health and wellness
Online Chair Yoga Viable Exercise for Isolated Older Adults with Dementia
Novel Study Examines Feasibility of Chair Yoga Intervention Using Zoom During the Pandemic
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A noninvasive and low-impact intervention, chair yoga is practiced sitting or standing using a chair for support.
« Online Chair Yoga Viable Exercise for Isolated Older Adults with Dementia
Newswise — Dementia doesn’t just involve cognitive decline, it also involves deteriorating physical function. This major cause of limitation in activities of daily living in older adults with dementia requires safe, effective, and evidence-based nonpharmacological approaches. One such approach is chair yoga. A noninvasive and low-impact intervention, chair yoga is practiced sitting or standing using a chair for support and combines flexibility, balance, strength, breathing, relaxation, and mindfulness training.
Unfortunately, barriers such as lack of transportation, living in rural areas, relying on caregivers and especially the COVID-19 pandemic has prevented many older adults with dementia from participating in group-based in-person chair yoga classes. These burdens call for an innovative way to deliver a chair yoga intervention for those who cannot travel to a community center.
“The considerable time and cost associated with traveling to in-person yoga sessions over several weeks could be burdensome to many patients,” said Juyoung Park, Ph.D., senior author, principal investigator and a professor in the Phyllis and Harvey Sandler School of Social Work within Florida Atlantic University’s College of Social Work and Criminal Justice.
Researchers from FAU’s College of Social Work and Criminal Justice, Christine E. Lynn College of Nursing and Schmidt College of Medicine and collaborators, conducted a novel interdisciplinary study to evaluate a remotely supervised online chair yoga intervention targeted at older adults with dementia and measured clinical outcomes virtually via Zoom under the remote guidance. The study assessed the feasibility of this intervention and explored the relationship between chair yoga and clinical outcomes of pain interference, mobility, risk of falling, sleep disturbance, autonomic reactivity, and loneliness.
Results of the study, published in the journal Complimentary Therapies in Clinical Practice, showed that remotely supervised online chair yoga is a feasible approach for managing physical and psychological symptoms in socially isolated older adults with dementia based on retention (70 percent) and adherence (87.5 percent), with no injury or other adverse events.
“This finding is important, as older adults with dementia and their caregivers may be challenged in attempts to attend chair yoga programs at community facilities,” said Park, who conducted the research with her mentee and co-author Hannah Levine, a medical student at FAU. “Our telehealth-based chair yoga intervention was found to be convenient for both participants and their caregivers because it was easily accessible from home and did not require transportation or getting dressed, which reduced caregiver burden and stress.”
Participants in the pilot study took part in twice weekly 60-minute sessions for eight weeks. During the chair yoga session, the yoga interventionist was spotlighted in the Zoom screen to allow participants to see only the interventionist. This spotlighting enabled participants to focus on the yoga sessions without being distracted by other participants on the screen.
“Our study participants worked with a certified yoga interventionist and their caregivers and practiced breathing techniques and intentional practice; physical postures; and guided relaxation and visualization,” said Park.
Participants also interacted on Zoom with other participants or with the facilitator to maintain social bonds while maintaining physical distance. Psychosocial and physiological (i.e., cardiac) data were collected remotely at baseline, mid-intervention, and post-intervention.
“Remotely collected cardiac and psychosocial data can provide a more complete assessment of the effects of an intervention,” said María de los Ángeles Ortega Hernández, DNP, APRN, GNP-BC, PMHNP-BC, CDP, FAANP, FAAN, director of the FAU Louis and Anne Green Memory and Wellness Center, associate dean of clinical practice and professor, FAU Christine E. Lynn College of Nursing. “Importantly, online chair yoga classes provide a means of reducing health disparities by opening access to interventions for persons who are unable to travel to a clinic or facility.”
The primary aim of the study was to assess the feasibility (retention, adherence, and safety) of conducting a remotely supervised, home-based, online chair intervention and completing outcome measures virtually. The secondary aim was to examine the relationship between the intervention and chronic pain, physical function, or psychological symptoms. Finally, an exploratory aim was to evaluate the ease and ability of caregivers and participants to record cardiac data remotely for offline analyses of the effect of the intervention on parasympathetic regulation and overall heart rate.
“An important feature of our technology-based intervention is that it could allow socially isolated older adults with dementia who are living at home, especially those in underserved communities where people are becoming more digitally connected, to receive remotely supervised chair yoga that provides physical, social and psychological benefits,” said Lisa Ann Kirk Wiese, Ph.D., co-author and an associate professor, FAU’s Christine E. Lynn College of Nursing.
Study co-authors are Keri Heilman, Ph.D., an assistant professor in the School of Medicine, University of North Carolina, Chapel Hill; Marlysa Sullivan and Jayshree Surage, both with the Maryland University of Integrative Health; Lillian Hung, Ph.D., an assistant professor and Canada Research Chair in Senior Care, University of British Columbia, School of Nursing; and Hyochol “Brian” Ahn, Ph.D., a professor and associate dean for research, Florida State University, College of Nursing.
“Results from our study can inform future research and practice in implementation of online chair yoga or other exercise program for promoting health and wellness in older adults with dementia living at home,” said Park.
This work was supported by FAU’s Division of Research, FAU’s Institute for Human Health and Disease Intervention (I-Health) and the Marcus Institute of Integrative Health at FAU Medicine.
– FAU –
About Florida Atlantic University: Florida Atlantic University, established in 1961, officially opened its doors in 1964 as the fifth public university in Florida. Today, the University serves more than 30,000 undergraduate and graduate students across six campuses located along the southeast Florida coast. In recent years, the University has doubled its research expenditures and outpaced its peers in student achievement rates. Through the coexistence of access and excellence, FAU embodies an innovative model where traditional achievement gaps vanish. FAU is designated a Hispanic-serving institution, ranked as a top public university by U.S. News & World Report and a High Research Activity institution by the Carnegie Foundation for the Advancement of Teaching. For more information, visit www.fau.edu.
Source: Florida Atlantic University
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Lifestyle
Clinical Trials Expand Patients’ Treatment Options
Clinical trials play a crucial role in developing effective treatments for chronic health conditions. They evaluate safety and efficacy, but low enrollment delays drug approvals, limiting patient options.
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(Family Features) For health conditions with no cure, effective treatments are the next best option. However, in order to make medical interventions including new drugs, devices, vaccines and lifestyle modifications available, they must undergo a thorough evaluation process to demonstrate their benefits.
Clinical trials are an important part of this process because they provide data for researchers on the effectiveness of various treatments and interventions. However, many myths about clinical trials deter people from enrolling. In fact, more than 70% of clinical trials are delayed at least one month due to unfulfilled enrollment, according to the “Journal of Medical Internet Research.”
Delays create barriers to the drug approval process and result in fewer available treatments for chronic conditions like Crohn’s disease and ulcerative colitis. The experts at the Crohn’s & Colitis Foundation offer these facts about the importance of clinical trials:
- More patients can benefit from clinical trials While hundreds of participants may take part in a trial, the results can lead to new care and treatment options for an entire patient community.
- Clinical trials lead to better and improved medications. For a new treatment to be approved, it needs to demonstrate a meaningful benefit to patients, such as improved outcomes, treating a wider range of symptoms, fewer side effects or more convenience for patients.
- They provide information. Clinical trials provide evidence of a treatment’s effectiveness and safety that can be used to guide patient care.
- Trials test safety and efficacy. Clinical trials are conducted in four phases. During the first phase, the main objective is to assess the safety of a new treatment. Experimental treatments only advance to the next stages if they pass certain safety and efficacy standards
. - They help prevent bias. In a randomized controlled trial, the effects of treatment with a new drug are compared with that of a control group – either a placebo (a treatment that looks identical to the new drug but contains no active medicine) or the current standard of care. Treatment assignments are “randomized,” which means neither the trial doctors nor the participants choose which treatment each participant will receive.
How Clinical Trials Work
Before a clinical trial begins, a research team develops a clinical trial protocol. This is the research plan that describes who can join the trial, which treatments the participants will receive, what questions the researchers will try to answer, how long the trial will last and how participant privacy and safety will be protected.
Conducting clinical research relies on volunteer trial participants. Those interested in joining a clinical trial meet with clinical research professionals to discuss the trial, treatments, eligibility requirements and expectations.
Joining a Trial
If you are interested in participating in a clinical trial, do some research. Your doctor may not be aware of or proactively tell you about trials you may be eligible to join. If you find a clinical trial you may be interested in joining, discuss the trial with your doctor and other health care professionals on your research team.
Foundations supporting chronic conditions can be a good source of information. For example, you can learn more about trials affecting individuals with inflammatory bowel disease by exploring the Clinical Trials Community at crohnscolitisfoundation.org.
Photo courtesy of Shutterstock
SOURCE:
Crohn’s & Colitis Foundation
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News
Why community pharmacies are closing – and what to do if your neighborhood location shutters
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Lucas A. Berenbrok, University of Pittsburgh; Michael Murphy, The Ohio State University, and Sophia Herbert, University of Pittsburgh
Neighborhood pharmacies are rapidly shuttering.
Not long ago, Walgreens, one of the nation’s biggest pharmacy chains, announced plans to close 1,200 stores over the next three years. That’s part of a larger trend that has seen nearly 7,000 pharmacy locations close since 2019, with more expected in the coming years.
Many community pharmacies are struggling to stay open due to an overburdened workforce, shrinking reimbursement rates for prescription drugs and limited opportunities to bill insurers for services beyond dispensing medications.
As trained pharmacists who advocate for and take care of patients in community settings, we’ve witnessed this decline firsthand. The loss of local pharmacies threatens individual and community access to medications, pharmacist expertise and essential public health resources.
The changing role of pharmacies
Community pharmacies – which include independently owned, corporate-chain and other retail pharmacies in neighborhood settings – have changed a lot over the past decades. What once were simple medication pickup points have evolved into hubs for health and wellness. Beyond dispensing prescriptions, pharmacists today provide vaccinations, testing and treatment for infectious diseases, access to hormonal birth control and other clinical services they’re empowered to provide by federal and state laws.
Given their importance, then, why have so many community pharmacies been closing?
There are many reasons, but the most important is reduced reimbursement for prescription drugs. Most community pharmacies operate under a business model centered on dispensing medications that relies on insurer reimbursements and cash payments from patients. Minor revenue comes from front-end sales of over-the-counter products and other items.
However, pharmacy benefit managers – companies that manage prescription drug benefits for insurers and employers – have aggressively cut reimbursement rates in an effort to lower drug costs in recent years. As a result, pharmacists often have to dispense prescription drugs at very low margins or even at a loss. In some cases, pharmacists are forced to transfer prescriptions to other pharmacies willing to absorb the financial hit. Other times, pharmacists choose not to stock these drugs at all.
And it’s not just mom-and-pop operations feeling the pinch. Over the past four years, the three largest pharmacy chains have announced plans to close hundreds of stores nationwide. CVS kicked off the trend in 2021 by announcing plans to close 900 pharmacy locations. In late 2023, Rite Aid said that thousands of its stores would be at risk for closure due to bankruptcy. And late in 2024, Walgreens announced its plans to close 1,200 stores over the next three years.
To make matters worse, pharmacists, like many other health care providers, have been facing burnout due to high stress and the lasting effects of the COVID-19 pandemic. At the same time, pharmacy school enrollment has declined, worsening the workforce shortage just as an impending shortfall of primary care physicians looms.
Why pharmacy accessibility matters
The increasing closure of community pharmacies has far-reaching consequences for millions of Americans. That’s because neighborhood pharmacies are one of the most accessible health care locations in the country, with an estimated 90% of Americans living within 5 miles of one.
However, research shows that “pharmacy deserts” are more common in marginalized communities, where people need accessible health care the most. For example, people who live in pharmacy deserts are also more likely to have a disability that makes it hard or impossible to walk. Many of these areas are also classified as medically underserved areas or health professional shortage areas. As pharmacy closures accelerate, America’s health disparities could get even worse.
So if your neighborhood pharmacy closes, what should you do?
While convenience and location matter, you might want to consider other factors that can help you meet your health care needs. For example, some pharmacies have staff who speak your native language, independent pharmacy business owners may be active in your community, and many locations offer over-the-counter products like hormonal contraception, the overdose-reversal drug naloxone and hearing aids.
You may also consider locations – especially corporate-owned pharmacies – that also offer urgent care or primary care services. In addition, most pharmacies offer vaccinations, and some offer test-and-treat services for infectious diseases, diabetes education and help with quitting smoking.
What to ask if your pharmacy closes
If your preferred pharmacy closes and you need to find another one, keep the following questions in mind:
• What will happen to your old prescriptions? When a pharmacy closes, another pharmacy may buy its prescriptions. Ask your pharmacist if your prescriptions will be automatically transferred to a nearby pharmacy, and when this will occur.
• What’s the staffing situation like at other pharmacies? This is an important factor in choosing a new pharmacy. What are the wait times? Can the team accommodate special situations like emergency refills or early refills before vacations? Does the pharmacist have a relationship with your primary care physician and your other prescribers?
• Which pharmacies accept your insurance? A simple call to your insurer can help you understand where your prescriptions are covered at the lowest cost. And if you take a medication that’s not covered by insurance, or if you’re uninsured, you should ask if the pharmacy can help you by offering member pricing or manufacturer coupons and discounts.
• What are your accessibility needs? Pharmacies often offer services to make your care more accessible and convenient. These may include medication packaging services, drive-thru windows and home delivery. And if you’re considering switching to a mail-order pharmacy, you should ask if it has a pharmacist to answer questions by phone or during telehealth visits.
Remember that it’s best to have all your prescriptions filled at the same pharmacy chain or location so that your pharmacist can perform a safety check with your complete medication list. Drug interactions can be dangerous.
Community pharmacies have been staples of neighborhoods for more than a century. Unfortunately, current trends in pharmacy closures pose real threats to public health. We hope lawmakers address the underlying systemic issues so more Americans don’t lose access to their medications, health services and pharmacists.
Lucas A. Berenbrok, Associate Professor of Pharmacy and Therapeutics, University of Pittsburgh; Michael Murphy, Assistant Professor of Pharmacy Practice and Science, The Ohio State University, and Sophia Herbert, Assistant Professor of Pharmacy, University of Pittsburgh
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Lifestyle
A How-To Guide for Participating in Clinical Trials
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(Family Features) Clinical trials help researchers studying chronic conditions answer important questions about the diseases and their treatment options. However, uncertainty about what to expect and a lack of knowledge about how to get started can prevent patients from joining a clinical trial.
Choosing to take part in a clinical trial means helping a study team figure out if a new method of diagnosis, treatment or prevention is effective. If you live with a chronic condition, such as Crohn’s disease or ulcerative colitis, and want to help find answers for others who share your experience, a clinical trial is an option to consider.
Once you identify a study that interests you, you’ll want to talk with the professionals involved in your ongoing treatment, a clinical research coordinator and your family to gather information necessary to determine whether the clinical trial is a good fit.
To find additional information about clinical trials and begin exploring trials in your area, visit crohnscolitisfoundation.org, and consider these steps for participating in a trial.
1. Talking with Your Doctor
Your gastroenterologist and other care providers can help determine whether a clinical trial is right for you and may be able to help point you toward recommended trials. It’s important to ask if or how your doctor will continue to be involved in your care if you participate in a trial.
2. Finding a Study
If you need help beyond your care team in identifying clinical trial opportunities in your area, organizations dedicated to your condition can be a good resource. For example, the Crohn’s & Colitis Foundation offers an online Clinical Trial Finder for individuals with inflammatory bowel disease.
3. Talking with the Research Coordinator
A clinical trial research coordinator can provide details specific to your circumstances and needs. You can discuss potential benefits and risks, why the trial is being conducted and who is involved in the health care team. You can talk about past treatments and how this study may differ from your previous experiences. Other questions you might ask include what your options are if the trial doesn’t work, any costs you might expect and what your personal commitment will be.
4. Evaluating the Fit for You
Once you have the necessary information, you’ll be able to consider whether you’re ready to move forward with registering for the trial. You’ll want to weigh factors like your time commitment, travel distance and whether the trial will affect your personal or professional obligations.
Photos courtesy of Shutterstock
SOURCE:
Crohn’s & Colitis Foundation
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