Ask yourself these 5 questions:

1. Do you understand the importance of conducting medication reviews with all your patients?
2. Can you confidently discuss the medications used in the treatment of pelvic floor, gastrointestinal (GI), and genitourinary conditions?
3. Are you able to describe the common side effects of medications routinely used in pelvic health?
4. Can you analyze the impact medications may have on a patient’s complaints and their treatment plan and outcomes?
5. Are you able to effectively communicate with patients and other healthcare providers about medications?

If you answered "no" to any of these questions or are preparing for an upcoming PRPC or WCS exam, the Pharmacologic Considerations for the Pelvic Health Provider course is designed for you!

The Role of Medication Review in Rehabilitation Therapy
While managing medications is not within the scope of practice for rehabilitation therapists, it is crucial to review patient medications during the initial evaluation and on an ongoing basis. Therapists must assess the impact of medications on treatment and patient outcomes to ensure patient safety.

Why Pharmacology Knowledge Matters!
Aging Population: With an aging population, many patients over the age of 65 are on more than five medications, increasing the risk of side effects, adverse drug reactions, and drug interactions.

Informed Discussions: A solid grasp of pharmacology allows therapists to engage in informed discussions with patients and collaborate effectively with other healthcare providers.

Alternative Approaches: Understanding pharmacology enables therapists to explore recent medications, supplements, or alternative approaches that may minimize side effects, mitigate impacts on quality of life, and enhance function.

Evidence-Based Practices: Keeping current on advancements in pharmacology is essential for delivering effective, evidence-based physical therapy interventions.

Benefits of Pharmacology Understanding in Rehabilitation
Safe and Effective Treatment: A thorough understanding of pharmacology helps provide safe and effective treatment.

Optimized Rehab Strategies: Knowledge of pharmacology allows therapists to optimize rehabilitation strategies.

Patient Empowerment: Educating patients about their medications empowers them to make informed decisions.

Recognizing Red Flags: Identifying potential red flags related to medication use.

Improved Collaboration: Pharmacology knowledge improves collaboration with other healthcare providers.

Course Offering
Join Kristina Koch for the virtual course Pharmacologic Considerations for the Pelvic Health Provider on August 17th to deepen your understanding and stay up-to-date on the medications used in treating pelvic floor and women's and men's health dysfunctions. This course will provide you with the essential knowledge to confidently manage medication-related aspects of patient care, ensuring better outcomes and enhanced patient safety.

AUTHOR BIO
Kristina Koch, PT, DPT, MS, Board Certified Specialist in Women's Health PT (2013-2023), CLT

Kristina received her Master of Science in Physical Therapy in 1996 from Springfield College in Massachusetts. In 2001, while living in the Los Angeles area, Kristina started specializing in the treatment of pelvic floor dysfunction including bowel/bladder issues and pelvic pain, and in 2021, she went on to earn her doctorate of physical therapy from The College of St. Scholastica. During her time in Los Angeles, she was fortunate to work with and, be mentored by fellow Herman and Wallace faculty member, Jenni Gabelsburg, DPT, WCS, MSc, MTC. Kristina is a Board Certified Specialist in Women's Health Physical Therapist (2013-2023) by the American Board of Physical Therapy Specialties. She then received her lymphatic therapist certification (CLT) in 2015.

Kristina has successfully helped establish women’s health and pelvic floor physical therapy programs in San Diego, California, and Colorado Springs, CO where she currently works in private practice. Kristina treats men, women, children, trans and gender non-binary individuals in her practice. In addition, Kristina serves as a guest lecturer for graduate physical therapy students at Regis University in Denver, CO, and provides educational lectures to medical providers and local community groups. Outside of work, Kristina enjoys spending time with her husband and two children, skiing, running, and hiking.

Kristina Koch, PT, DPT, is a board-certified clinical specialist in women’s health physical therapy and a certified lymphedema therapist. Kristina has been treating pelvic health conditions in individuals of all ages and genders since 2001 and works in private practice in Colorado Springs, CO. She has served as a guest lecturer for the pelvic health curriculum at Regis University in Denver and for the 3^rd year medical students at the University of Colorado, Colorado Springs campus. She is the creator of Pharmacologic Considerations for the Pelvic Health Provider.

Although it is not within the scope of practice for rehab therapists to manage medications, it’s important that we review patient medications during the initial evaluation and on an ongoing basis. Therapists have a duty to assess medications impact on treatment and patient outcomes and to ensure patient safety. The population is aging and many patients over the age of 65 are on more than 5 medications, increasing the risk of medication side effects, adverse drug reactions, and drug interactions.

Primary care providers spend approximately 14-17 minutes with a patient during a visit, and the patient gets about 5 minutes to discuss their concerns, leaving little time for medication reconciliation or discussion regarding medication side effects (Tai-Seale, McGuire & Zhang, 2007). As therapists, we tend to see our patients for longer periods of time and more frequently, giving the patient more of an opportunity to discuss their signs and symptoms. Additionally, patients referred for pelvic health issues are often seeing multiple specialty providers (Ob/Gyn, urology, urogynecology, pain management, etc.) for their care, and each one is typically prescribing medications, potentially leading to polypharmacy. Understanding a medication’s actions, its impact on therapy, the side effects, and potential adverse drug reactions, can help guide treatment and improve patient outcomes.

A recent patient example is a post-menopausal cisgender female, referred by her primary care physician, for urinary urgency and nocturia. Her past medical history was significant for breast cancer. Her medications included an aromatase inhibitor, antihistamine due to seasonal allergies, and Vitamin C. After reviewing her medications and history, I recommended a non-hormonal vaginal lubricant and within 2 weeks her symptoms were 80% improved. Understanding the side effects of her medications allowed me to educate the patient about the effects of her medication and how to manage her symptoms.

More and more patients are attending therapy through direct access. As the first point of contact for patients, it's imperative that rehab professionals have a foundational knowledge of the medications often prescribed to treat pelvic floor conditions, GI, GU, and reproductive health issues. The ability to have educated conversations with our patients and other healthcare providers involved in their care can greatly improve the quality of care and outcomes, and maintain patient safety. The ability to discuss medications, vitamins, and supplements or complementary alternatives, that can minimize side effects, have fewer impacts on quality of life, and enhance function is an integral part of comprehensive patient care.

Join Kristina on Saturday, January 7, 2023, for Pharmacologic Considerations for the Pelvic Health Provider. This one-day, remote course will discuss the importance of understanding pharmacology and medication review, the current research regarding the pharmacologic treatment of numerous pelvic and reproductive health conditions and their side effects, drug interactions, and non-pharmacologic alternatives that are available for pelvic and reproductive health. Registration information and additional details are available at www.hermanwallace.com. #hermanwallacepelvicrehab, @hermanwallacepelvicrehab

References:

Ciccone, C. D. (2007). Pharmacology in Rehabilitation. (4^th ed.). F.A. Davis Company.

Tai-Seale, M., McGuire, T.G., & Zhang, W. (2007). Time allocation in primary care office visits. Health Services Research. 42(5), 1871-1894. Doi: 10.1111/j.175-6773.2006.00689.x

Janes, M., & Kornetti, D. (2017). Medications: defining the role and responsibility of physical therapy practice. https://www.fsbpt.org/Portals/0/documents/free-resources/WinterForum2017Medications.pdf?ver=pf8bn4ZwoorAAg1PECZLfw%3D%3D

Pharmacologic Considerations for the Pelvic Health Provider

Course Dates:
January 7, 2023

Price: $200
Experience Level: Beginner
Contact Hours: 7.5

Description:  This seven-and-a-half hour, one-day remote learning course will discuss medications used for the treatment of pelvic floor and genitourinary conditions as well as common side effects of medications routinely used for pelvic floor dysfunction. This course will be taught by Kristina Koch, PT, DPT via Zoom. Medications for constipation and GI dysfunction, as well as pelvic pain conditions such as Vulvodynia, Chronic Prostatitis, and Endometriosis, will be covered. The course will also cover medications and side effects in Gender-Affirming Care for patients who are transitioning.

Kristina Koch, PT, DPT, is a board-certified women’s health physical therapist and certified lymphedema therapist who is the author/instructor of the remote course Pharmacologic Considerations for the Pelvic Health Provider. She has been treating pelvic health dysfunction in all ages and genders since 2001. Kristina works in private practice in Colorado Springs, CO, and has served as a guest lecturer for the pelvic health content at Regis University in Denver and the University of Colorado.

Did you know that the median length of time a primary care provider spends with a patient is 15 minutes? This breaks down to approximately 5 minutes for the patient to talk about their health concerns and 5 minutes for the health care provider to speak, with the rest being applied toward paperwork (1). After this appointment, the patient may not be seen again for several months or even a year. Medication side effects that impact the patients’ quality of life, or create new symptoms, can be easily overlooked.

I created the course, Pharmacologic Considerations for the Pelvic Health Provider because, with direct access to physical and occupational therapy services, a greater responsibility has been placed upon the therapist to take on more of a role as a primary care provider. We must ensure that all factors contributing to a patient’s signs and symptoms are considered. This includes reviewing and assessing if medications or supplements may be causative.

As therapists, we typically spend more time with our patients than their primary care providers. We are seeing them for longer periods during a treatment session and will see them numerous times throughout a month or longer. As a result, our patients have a greater opportunity to discuss their signs and symptoms with us versus their physician or primary care provider. Therefore, understanding how medications may be impacting a patient is essential. Being able to educate the patient about the side effects of the medications they are taking and how the medications may be contributing to their complaints can enhance the value of the treatment session.

By possessing this knowledge and understanding of the medications that are prescribed to treat pelvic health, therapists can have educated conversations with our patients and other health care providers involved in their care. The ability to discuss the most recent medications and supplements or complementary alternatives, that may minimize side effects or have fewer impacts on quality of life and enhance function, is an integral part of patient care.

Join Kristina to dive into Pharmacologic Considerations for the Pelvic Health Provider. This one-day, virtual course will discuss the importance of understanding pharmacology and review commonly prescribed medications. Kristina also spends time explaining current research pertaining to the pharmacologic treatment of numerous pelvic and reproductive health conditions, medication side effects, drug interactions, and non-pharmacologic alternatives. Medications discussed include those for constipation and GI dysfunction, pelvic pain conditions (including vulvodynia, chronic prostatitis, and endometriosis), as well as medications and side effects in Gender-Affirming Care for patients who are transitioning.

Upcoming 2022 course dates for Pharmacologic Considerations for the Pelvic Health Provider include:

• May 15
• July 9
• November 19

References:

1. Tai-Seale, M., McGuire, T. G., & Zhang, W. (2007). Time allocation in primary care office visits. Health Services Research. 42(5), 1871-1894. Doi:10.1111/j.175-6773.2006.00689.x
2. Ciccone, C. D. (2007). Pharmacology in Rehabilitation. (4^th). F.A. Davis Company.