Implementation of Shared Medical Appointments to Address Cardiovascular Disease Risk in Patients With Metabolic Syndrome

Abstract

Metabolic syndrome is a condition in which the components – central adiposity, insulin resistance, atherogenic dyslipidemia, and elevated blood pressure - confer increased cardiovascular morbidity and mortality. A pilot clinical practice improvement project was developed and implemented using shared medical appointments to address cardiovascular disease risk in adult patients at a rural health care clinic on the southern Kenai Peninsula, Alaska who met the diagnostic criteria for metabolic syndrome. Statistically significant improvement in self-reported minutes of exercise was demonstrated for the nominal group of participants. Participants were at least as satisfied or more satisfied with shared medical appointments compared to traditional medical appointments. Limitations aside, the Doctor of Nursing Practice (DNP) project demonstrated the feasibility of using shared medical appointments to address cardiovascular disease risk in this patient population. There is need for additional research into the “physiology,” or curricular and other structural and procedural elements of shared medical appointments for patients with metabolic syndrome that would afford decreased cardiovascular disease risk. The Doctor of Nursing Practice (DNP) project goals were in accordance with the overarching aims of the National Quality Strategy that build on the Institute for Healthcare Improvement’s Triple Aim – cost-effective, patient-centered, quality care that improves health.