In The News

How to Prescribe Physical Activity in Patients With Obesity

Medscape Medical News: Carla Nieto Martínez

Exercise should no longer be a mere "complement" or a standard recommendation within healthy lifestyle guidelines, say experts. Recent evidence confirms its physiological importance and endorses its beneficial and therapeutic effects on overall health, particularly in the case of obesity and its comorbidities. These findings emphasized the reasons to include exercise prescription in addressing this condition. This conclusion emerged from discussions among experts in Physical Activity and Sports Sciences during the XIX Congress of the Spanish Society for Obesity, where the role of physical exercise as a therapeutic strategy was analyzed from various perspectives.

Javier Butragueño, PhD, coordinator of the Exercise Working Group at the Spanish Society of Obesity, emphasized the need to "reposition" the role of exercise and the message conveyed to the population. "We must move beyond the typical recommendation to 'just walk' and rethink this message. When working with patients with obesity, you realize that, for example, the guideline of 10,000 steps per day makes little sense for those who weigh 140 kg, have been sedentary for a long time, and have not reached 2000 daily steps. Clinically, it becomes evident that current recommendations may not align with the needs of these patients," he said.

Precision Focus

Butragueño highlighted the necessity of shifting the central focus from weight-related variables alone. While weight is crucial, evidence suggests that it should be evaluated along with other strategies, such as nutrition and pharmacology.

"The approach must change to view exercise as a metabolism regulator," said Butragueño. "For specialists, this means educating the population about the need to stay active for overall health. This is a disruptive message because the prevailing idea, almost obsessive, associates exercise primarily with weight loss, a completely incorrect approach that can even be detrimental in some cases."

Butragueño emphasized the supportive role of physical exercise in interventions for these patients. "Data show that it is both an enhancer and a co-adjuvant in strategies that also include psychology and endocrinology. It should be part of the approach to obesity but individualized and phenotyped to give physical activity the necessary dimension in each specific case."

As an example of this adaptability in therapeutic strategy, Butragueño referred to addressing binge eating disorder. "In this case, specialists must acknowledge that sports are a third-line option, always behind the psychologist, who plays a primary role. Exercise is used to enhance the emotions triggered through its practice, considering that many of these patients maintain a very negative relationship with their bodies."

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HHAU x bttn: Medical Supply Platform Webinar

Thursday, February 29 · 2:00 – 3:00 p.m.

Please join HHAC for a webinar with bttn, The Medical Supply Platform. bttn will be showcasing how purchasing is made easy but most importantly how they are lowering costs on your medical supply bill. Come and find out why so many are switching to bttn. 

Google Meet joining info
Video call link: https://meet.google.com/beb-erza-rxm
Or dial: ‪(US) +1 413-340-2463 PIN: ‪596 822 961#
More phone numbers: https://tel.meet/beb-erza-rxm?pin=2106479611043

 

Hospice Comprehensive Assessment Measure Fact Sheet + Hospice Item Set Manual Update

  • The Centers for Medicare & Medicaid Services (CMS) posted a Fact Sheet for the Hospice Comprehensive Assessment Quality measure. The document provides clarification on the measure and guidance on how to calculate the Hospice Comprehensive Assessment Measure for your hospice as well as FAQs for the measure. The Comprehensive Assessment quality measure captures whether seven key care processes were conducted upon a patients’ admission to hospice and was first publicly reported on Care Compare in 2018.
  • The Hospice Item Set (HIS) Manual has been updated to remove COVID-19 public health emergency references, revise the Annual Payment Update (APU) penalty to reflect the current four percent (4%), revise the terminology related to the Consensus Based Entity (CBE) and make some date changes.

A Change Table outlining all the revisions is available here.

 

No changes are necessary for hospice operations relative to the HIS.

 

Medical Aid in Dying Waiting Period Would Shorten from 15 days to 48 Hours Under Colorado Bill

Greeley Tribune | By Meg Wingerter

A bill in the Colorado legislature would shorten the mandatory waiting period for medical aid in dying from more than two weeks to two days, opening the option to more critically ill people, but raising concerns for some about rushed decisions.

Colorado legalized medical aid in dying in 2016, when voters passed Proposition 106. Under the law, two physicians must agree that an adult patient is mentally competent to make the decision to die and would have less than six months until natural death. If approved, the person would then give themselves a drug cocktail meant to cause death painlessly.

Under current Colorado law, a patient has to request medical aid in dying twice, at least 15 days apart, before they can get a prescription. Senate Bill 24-068 would shorten the timeline to 48 hours, and allow physicians to waive the waiting period if they believe the patient will die in less than two days.

It would also allow people who aren’t Colorado residents to end their lives under the state’s law, and let advanced practice registered nurses prescribe the drug cocktail. Colorado allows APRNs to prescribe most drugs, but limits medical aid in dying prescriptions to physicians…

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Final Rule Strengthens Social Needs Programs for Seniors Aging in Place

McKnight’s Home Care | By Adam Healy
 
The Administration for Community Living on Tuesday released a final rule affecting the Older Americans Act (OAA) — the first significant change to the act in more than 35 years.

Among various updates, ACL’s rule specifies what people are eligible for assistance under the OAA, clarifies how federal funds can be used to provide supportive services, and spells out requirements for state and local programs helping older adults aging in place. There have been small modifications to the act in recent years, but this week’s final rule marks the first major changes to the OAA since 1988, according to the ACL.
 
“Updates are needed to align regulations to the current statute and reflect the needs of today’s older adults,” ACL wrote in a Notice of Proposed Rulemaking in June 2023. “[The rule] aims to better support the national aging network that delivers OAA services and improve program implementation, with the ultimate goal of better serving older adults.”
Also since 1988, the population of older adults in the United States has nearly doubled, seniors on average are living longer and expectations for aging have changed, according to ACL. The provisions finalized in the rule aim to reflect these changing standards and provide more comprehensive care for aging adults. Its ultimate goal, ACL noted, is helping seniors receive services and support to live at home and in their communities as they age.
 
“The overwhelming majority of Americans want to live in their own homes as they age … For many, this is possible because of the programs and services provided through the Older Americans Act,” Alison Barkoff, ACL administrator and the assistant secretary for aging, said in a statement. “The updated regulations strengthen the stability and sustainability of these programs.”
 
Some services provided by OAA programs include rides to medical appointments, nutritious meals, in-home care and support to family caregivers, according to Barkoff.
The final rule also solidifies flexibilities put in place during the COVID-19 pandemic that promoted aging in place. For example, the rule now allows some meal programs to offer carry-out meals for seniors.
 
In 2022, USAging, the national association that supports area agencies on aging called for OAA expansion. Meanwhile, workforce-challenged aging service providers — including home care agencies — struggle with a lack of resources to serve the growing number of older adults in need.
 
The rule has been filed in the Federal Register and is scheduled for publication on Feb. 14.

 
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