The aging population challenges sustainable development worldwide, particularly impacting the medical and long-term care systems. Professor Chen Liang-Kung, head of Taipei Municipal Guandu Hospital and professor at National Yang-Ming Chiao Tung University (hereinafter referred to as NYCU), confirms that older people embrace value-oriented holistic healthcare can improve their physical and cognitive functions and achieve a better quality of life.
Prof. Chen’s team collaborated with several medical centers, district hospital clinics, primary clinics, and public health centers to conduct a one-year randomized distribution test in Taipei City, New Taipei City, Yilan County, and Hualian County. In the test, they reached out to 398 older people with an average age of 72.3 years old and three or more chronic diseases to participate in the research while also training clinical doctors in multiple chronic disease management, polypharmacy, and prevention of disability and dementia.
In the research, older people were divided into two groups; those in the experimental group received not only holistic healthcare from clinics but also interventions in multiple aspects of life, including exercise, cognitive training, nutritional counseling, and social bonding in group classes. Meanwhile, those in the control group received only traditional healthcare. After a one-year trial, the research team discovered that older people who received holistic healthcare and living interventions significantly improved their physical and cognitive functions, maintaining their quality of life at a better level while aging. In addition, the elderly in the experimental group exhibited significant improvements in controlling chronic diseases and minimizing inappropriate medication use, highlighting the potential benefits of the holistic approach. The results of this study were acknowledged by the prestigious medical journal Lancet Healthy Longevity, which not only accepted the publication but also wrote a review.
The journal’s review considers the team’s inclusion of quality-of-life and value-based healthcare indicators in their research a bold innovation. The journal’s review regards the team’s incorporation of quality-of-life and value-based healthcare indicators in their research as a daring innovation. This approach contrasts traditional clinical healthcare, focusing exclusively on bioindicators such as blood pressure, blood glucose, and cholesterol. By including these additional indicators, healthcare systems can more effectively capture a comprehensive picture of the quality of life and holistic healthcare for older individuals. Lancet Healthy Longevity suggests that the international community could follow this research design in Taiwan to verify the effectiveness of holistic care in the future. In addition, the low rates of smoking and alcohol consumption among older people in this study, which are 5% and 9%, respectively, emphasize the importance of this study. Since smoking and alcohol cessation are health risks that are relatively easy to improve in short-term studies, the low rates of smoking and alcohol use in this study could further highlight the effectiveness of these interventions, which come from holistic healthcare and multiple life interventions.
According to Chen, 5% of older people with multiple and complex cares needs account for 50% of the total healthcare expenditure in the U.S. long-term care systems. At the same time, most seniors have numerous diseases and disabilities. This phenomenon can be applied to countries worldwide. Due to the complexity of medical conditions and healthcare treatments, it is challenging for medical and long-term care systems to establish a holistic healthcare model, leading to unmanageable medical expenses and affecting older people’s quality of care and life. Thus, countries worldwide are committed to developing effective models combining disease treatments to prevent disability and dementia.
Professor Chen also pointed out that Taiwan’s rapidly aging population is the biggest challenge to the sustainable development of Taiwanese society. The frequency of elderly citizens’ clinical visits reaches thirty times per year. In contrast, the length of disability-adjusted life years continues to rise. Although the health insurance system in Taiwan provides affordable and convenient services for disease treatment, the prevention of disability and dementia and other preventive care systems remain isolated from other government departments and have not yet integrated with other medical services covered by health insurance. This situation should be improved since elderly people with chronic diseases have a higher risk of subsequent disability and dementia. Therefore, providing clinically effective integrative interventions coordinating with chronic disease management is important.
In this research, the team extended the scope of the experiment to include people with multiple chronic diseases based on the research publication Taiwan Health Promotion Intervention Study for Community-Dwelling Elders (THISCE) in 2020, which demonstrated the effectiveness of multiple interventions covering exercise, cognitive training, nutritional counseling, and community-based health education in reducing the decline of strength and mental abilities. Through multiple life interventions combined with chronic disease management, the team collaborates with clinical doctors to explore the best service model for local elderly healthcare with a more comprehensive spirit of holistic healthcare and a value-oriented medical framework.
With financial support from the National Health Research Institutes, Chen’s team will promote the research results in the Guandu communities. When patients in the Guandu communities visit Taipei Municipal Guandu Hospital, the team will assess the conditions of different patients and make referrals if needed. The hospital will open multi-functional spots in the communities and execute multi-dimensional life interventions based on their comparative studies ranging from exercise, cultural events, recreation, networking activities, nutrition, health education, etc. Furthermore, the team considers the different needs of people in the community. They will thus build a virtual Guandu community, offering online courses for people who do not have time to attend the courses in person, so they can also have an opportunity to change their lives. The elderly people in the community can receive effective life interventions in addition to chronic disease management. The team led by Professor Chen seeks to build a healthy and long-lived community with a long-term goal of improving the living quality of the whole society.