This blog post was prepared by RNO Website Committee Chair Joan Grant Keltner.
- Over three million individuals who live in rural areas use the Veterans Affairs for their medical care (AARP, 2016). These older individuals are more likely to take multiple medications to manage chronic health conditions. In one study, almost 77% of veteran geriatric patients seen in the Emergency Department had five or more prescription medications, with over 80% taking at least one high-risk medication (Morizio et al., 2021). Unfortunately, taking this number increases the risk for medication errors and can lead to other deleterious side effects, such as falls. In examining useful interventions to improve medication adherence and management, the IMPROVE program used face-to face consultation, with recommendations, education, and other strategies. The IMPROVE program showed a 75% or greater improvement in the timing and dosages of prescribed medications, with a 14% decrease in potentially inappropriate medications. This pharmacist-led program is now available in local and rural Community-based Outpatient Clinics (CBOCs). More information about implementing a Rural Promising Practice is available at www.ruralhealth.va.gov or by email at rural.health.inquiry@va.gov. (Source: https://www.ruralhealth.va.gov/docs/promise/IMPROVE_OnePager_51117.pdf)
American Association of Retired Persons ([AARP], 2016). Chronic conditions among Americans. https://assets.aarp.org/rgcenter/health/beyond_50_hcr_conditions.pdf
Morizio, P. L., Mistry, V., McKnight, A., Pepin, M. J., Bryan, W. E., Owenby, R. K., Previll, L., & Ragsdale, L. C. (2021). Polypharmacy and high-risk medications in older veterans presenting for emergency care. Journal of Geriatric Emergency Medicine, 2(12), Article 3. https://institutionalrepository.aah.org/cgi/viewcontent.cgi?article=1007&context=jgem
- Over the last several years, rural physicians have progressively decreased in number while nurse practitioners (NPs) have increased, leaving a pathway for many NPs to meet the healthcare needs of individuals who live in rural areas. About 90% of NPs are certified in primary care, 70% deliver that care, and represent about one out of four rural providers (AANP, 2020, 2022). These statistics indicate NPs provide comprehensive care to rural patients through health promotion and prevention and management of chronic illnesses. Measuring this valuable care that results in positive health outcomes in rural patients is essential to share among ourselves but also with others who have an active voice in advancing our discipline.
AANP (2020, November 19). AANP highlights NP Role in providing accessible rural health care during pandemic. https://www.aanp.org/news-feed/aanp-highlights-np-role-in-providing-accessible-rural-health-care-during-pandemic
AANP (2022). 2022 AANP National Nurse Practitioner Workforce Survey — Preliminary analysis. https://storage.aanp.org/www/documents/NPFacts__111022.pdf?_gl=1*1j7cjqc*_gcl_au*MTYwNzE1MDI4NC4xNjk1MDg1MjY4
