Effect of student-led health interventions on patient outcomes for those with cardiovascular disease or cardiovascular disease risk factors: a systematic review

Abstract

Background: As the need for health care services rise, alternative service delivery models such as student-led health interventions become attractive alternatives to alleviate the burden on healthcare. Predominantly, studentled health interventions were free clinics servicing socially disadvantaged communities in the USA. A 2015 systematic review identified that students value these student-run clinics and reported skill and knowledge attainment from participating. Previous research has reported on patient satisfaction outcomes, but less frequently about the clinical outcomes patients accrue from these student-delivered services. As cardiovascular disease is the leading cause of death worldwide, this review aimed to explore the effectiveness of student-led health interventions through examining their impact on objective clinical outcomes, using the case of patients at risk of, or with, cardiovascular disease. Methods: A systematic literature search was conducted in eight electronic databases to identify student-led health interventions conducted on adults with a cardiovascular disease risk factor or established cardiovascular disease, and a clinical outcome of interest. Through double-blinded screening and data extraction, sixteen studies were identified for synthesis. Results: The majority of student-led health interventions for patients at risk of cardiovascular disease demonstrated a positive impact on patient health. Statistically significant changes amongst patients at risk of cardiovascular disease appeared to be associated with student-led individualised intervention or group-based interventions amongst patients with diabetes or those who are overweight or obese. The evidence was of moderate quality, as included studies lacked a control group for comparison and detail to enable the intervention to be replicated. Conclusions: Future research applying a student-led health intervention through a randomised control trial, with rigorous reporting of both student and patient interventions and outcomes, are required to further understand the effectiveness of this alternative service delivery model.

Student-Led discharge counseling program for High-Risk medications in a teaching hospital in Saudi Arabia: A pilot study

“…This preliminary non statistically significant result can be attributed to the pilot study design and the short study duration (over seven months) to detect significance. In particular, the impact on improvement on clinical parameters (TTR and HbA1C) was not ascertained due to the short follow up period of these outcomes ( Suen et al, 2020 ). Additionally, we found a non-significant difference in education and counseling as per hospital practice between the two groups; we associated such observation to the physical presence of students on the ward, which may have influenced the nurses' behavior to perform more discharge counseling for patients not visited by the APPE students (nurse education in the control group = 28% vs. 12% in the intervention arm).…”

“…The second aspect of this pilot study is to assess the feasibility of utilizing APPE pharmacy students in performing transition of care activities, hence improve and sustain pharmacy patient care services. Several literature and organizations voiced concern about resources limitation when extending pharmacy services, especially for clinical activities such as medication reconciliation, the transition of care, patient education, care coordination ( Hume et al, 2012 , Couture et al, 2016 , Scott et al, 2017 ) Abundance of studies described successful experiences in employing Pharmacy extenders such as residents, APPE and IPPE students and pharmacy technicians to deliver discrete functions that match their level of knowledge and training ( Dalal et al, 2010 , Dang et al, 2012 , Hayes and Hutchison, 2013 , Stebbins et al, 2013 , Szkiladz et al, 2013 , Adams et al, 2015 , Beggs and Karst, 2016 , Church et al, 2016 , Albano 2017, Hertig et al, 2017 , Rogers et al, 2017 , Vavra et al, 2018 , Plakogiannis et al, 2019 , O'Reilly et al, 2020 , Suen et al, 2020 ). Indeed, students in this study were able to implement a simple and structured transition of care program at no excess cost while ensuring such service is offered to patients at high risk of readmission.…”

Patient Outcomes from Student-Run Health Services: An Integrative Review

“…Earlier reviews have examined the learning outcomes that result for students involved in such clinics. 13–15 Smaller-scale reviews have also been published on health outcomes specifically for SRC patients with cardiovascular disease or risk factors 16 and on student-delivered care in a physical rehabilitation context, 17 but the totality of evidence related to patient outcomes for patients in SRCs has not yet been systematically explored. Seeking to address this gap in knowledge, this integrative review aims to synthesize literature evaluating clinical patient outcomes of SRCs.…”

Using a web-based platform to apply the Nutrition Care Process and capture nutrition outcomes and patient satisfaction in a student-led dietetic outpatient clinic: a pilot study

“…Student-led clinics are a way to reduce patients' costs and barriers to access health care and create a safe experiential learning space for students (Buckley et al, 2014). The available research on the effectiveness of student-led healthcare services is minimal (Kent & Keating, 2013;Suen et al, 2020). Students are rated highly in their respect for patients, sensitivity to confidentiality, and professionalism in various healthcare disciplines (Bennard et al, 2004;Forbes & Nolan, 2018;Hajioff & Birchall, 1999;Lafont et al, 1999).…”