February 05, 2023

Public institution Centro Poliklinika – the clinic of reforms

Centro Poliklinika is one of Lithuania's largest outpatient personal healthcare institutions, and one of the partners in the EUPAP project. The healthcare clinic has approximately 123,000 patients registered and nearly 1 million visitors per year and is often referred to as a clinic of reforms, innovations, and progress. Centro Poliklinika is one of the leading actors within its field in Lithuania. The vision for Centro Poliklinika is to be an innovative, modern, healthcare institution with reliable employees who can provide the highest standard of medical services, with the aim to motivate people to make healthier choices. The clinic strives to implement new effective medical and information technologies for a continuous improvement of the quality of services in order to be able to provide high quality care to their visitors.  

In Lithuania family doctors, dieticians, nurses, and physiotherapists have been involved in EUPAP. Healthcare specialists as well as personnel involved in the project coordination have been trained in the PAP-S method and all project material for implementation of PAP have been translated and adapted into the local context.

Implementation of PAP in the Lithuanian context

A  Physical Activity on Prescription (PAP) consulting room where a PAP-prescriber received patients opened 2021in Lithuania. The PAP consulting room  began operating on 25 September 2021, and a total of 147 patients were registered during the period 25 September 2021 and 1 November 2022. The consulting room has been open on Saturdays and some working days and three specialists - two dieticians and a physiotherapist – have provided patients with patient-centered consultations. All healthcare professionals at Centro Poliklinika are entitled to register patients for a PAP consultation. The services at the PAP consulting room, have not only been provided for Centro Poliklinika patients, but also for patients from other healthcare providers. A broad spectrum of diseases have been addressed during the EUPAP implementation, for example: anxiety, chronic back and neck pain, coronary artery disease, depression, diabetes mellitus I and II, chronic heart failure, hypertension, lipid disorders, metabolic syndrome, migraine, osteoarthritis, osteoporosis, overweight and obesity. 

During the initial phase, there were some difficulties with the registration of patients. This was due to the fact that the medical specialists were unfamiliar with EUPAP, but as time went by the specialists got more used to also informing patients about the availability of the Physical Activity on Prescription and if the patient agreed, a prescription for physical activity was written. All the steps in the process, (registering patients, consultations, issuing prescriptions) were recorded in the information system of the Centro Poliklinika, as well as in the national personal health care information system. This means that all patients receiving a PAP have been registered in the healthcare information system. In addition to a prescription for physical activity, the patient's body mass (body muscle, body fat) was also monitored during the initial visits, as well as at the repeated follow-up appointments with the patient; this was used as an indicator for any changes in the patient’s health status.

The Centro Poliklinika team have presented the objectives of EUPAP to the Ministry of Health, the Institute of Hygiene and a network of Public Health Bureaus. During the meeting, the clinic described how the program was adopted to the local setting and how the implementation process has been conducted. There is an interest in PAP in Lithuania, and the Ministry of Health is aiming to integrate EUPAP in existing healthcare programs in the country, but at this point, it is not clear exactly how or when this will happen

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