On the Road to Wellness

An innovative model for vascular health

Community-based disease prevention models have direct application to the workplace. They can be implemented easily and complement existing workplace wellness programs. The Hearts in Motion program has proven to be effective and can be replicated in the workplace to achieve healthy outcomes.

Hearts in Motion helps people manage their risk of vascular disease and achieve sustained behaviour change. Patients enroll in a three-month program of weekly exercise, nutrition planning, risk assessment and education. They work with a multidisciplinary team to set health goals, while their progress is evaluated at six months and again at one year.

The exercise ability of those in the program has improved by 20% which, when sustained, has been associated with a significant decrease in mortality. A weight loss of 5%, as was noted in patients at the three-month phase, can decrease vascular risk factors such as blood pressure and improve heart health. At the six-month follow-up, most patients maintained weight loss and women displayed continued weight loss of up to 10%.

A pharmacist intervention component was also initiated to improve adherence to medication that were recommended at the program’s completion. A pharmacist provided pharmaceutical care in collaboration with the team at one program site. Of all the drug-related problems identified by the pharmacist at the initial phase, 92% of the recommended resolutions were implemented. Also, patients participating in the pharmacist intervention had 63% medication adherence, compared with only 15% of those following usual care. The pharmacist intervention component of the program helped patients achieve targets for blood cholesterol and blood pressure management in cases where pharmacotherapy was needed.

Health behavior strategies related to goal setting, readiness to change and confidence measures are being evaluated using an evidence-based approach for application in other programs. As the research in Hearts in Motion continues, further study will focus on transitioning program components for duplication in several communities including the workplace.

Nicholas Giacomantonio is an associate professor of medicine at Dalhousie University, and a cardiologist at Queen Elizabeth II Health Sciences Centre in Halifax.

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© Copyright 2008 Rogers Publishing Ltd. This article first appeared in the May 2008 edition of WORKING WELL magazine.