Initial performance measures were used to identify remission and evaluate the effectiveness of lifestyle medicine treatments, according to expert consensus results published in 2017. American Journal of Lifestyle Medicine. These results may allow for more objective comparisons of lifestyle interventions and non-lifestyle treatments.^1,2

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“Many clinical practice guidelines [say it’s] Addressing lifestyle behaviors is important in the treatment of chronic diseases, but without measurable performance standards, it has not been possible to effectively assess patient progress and long-term outcomes following lifestyle medicine interventions. ,” John Kelly, MD, MPH, DipABLM, FACLM, founding president of the American Academy of Lifestyle Medicine, said in a press release. “These new performance indicators defined by a panel of experts will equip clinicians with the standards they need to measure treatment success and help them adopt evidence-based lifestyle medicine. ”¹

In a press release, lifestyle medicine is defined as a medical specialty that employs therapeutic lifestyle interventions as a primary therapy for treating chronic diseases such as cardiovascular disease, type 2 diabetes, and obesity. . Furthermore, he has six pillars of lifestyle medicine. Whole foods, a plant-based eating pattern, physical activity, restorative sleep, stress management, positive social connections, and avoidance of hazardous substances.¹

According to the experts, the final set group included 32 performance measures classified into 10 categories of diseases or health conditions. Heart risk factors. Heart Medications and Treatments. Patient-centered heart health. Hypertension; Type 2 diabetes and prediabetes; Metabolic syndrome; Inflammatory conditions; Patient-centered management of inflammatory conditions. and chronic kidney disease. The patient-centered measures were all related to quality of life, according to a press release.^1,2

The researchers found that lifestyle medicine was effective in reducing hypertension, including systolic and diastolic blood pressure, three months after starting a lifestyle intervention to address poor diet and lack of exercise. We selected specific measurements that demonstrate whether this is considered to be the case.¹ Other measures against hypertension included reducing the need for drugs and treatments known to be effective against hypertension.²

Measurements of cardiac function include echocardiographic evaluation of ejection fraction, need for coronary artery bypass grafting or percutaneous coronary intervention, and functional capacity. Cardiac risk factors include measurements of low-density lipoprotein cholesterol, triglycerides, waist-hip ratio, systolic and diastolic blood pressure, and cardiac C-reactive protein. Cardiac treatments and procedures include the administration of medications and the use of procedures, and patient-centered cardiac health measures include quality of life assessments.²

As measurements of diabetes type and prediabetes, the authors included three measurements: hbA1c, fasting serum glucose, and net decrease or no increase in medications, procedures, or surgeries between measurements. Experts say measurements of metabolic syndrome include waist circumference, triglycerides, high-density lipoproteins, blood pressure, fasting blood sugar levels, and the presence or absence of increased medications or treatments.²

Measures of inflammatory status and patient-centered measures included specific measures of cardiac CRP and specific inflammatory diseases, SF12 and visual analog scale pain scales, respectively. Measurements of chronic kidney disease included serum creatine, estimated glomerular filtration rate, and creatinine clearance.²

“You would not expect a surgery, procedure, or drug to be prescribed if there is no evidence that it works,” Carlsen said in a press release. “Our hope is that these standards will be widely adopted by healthcare professionals.”¹

References

1. The first performance standard published to measure the effectiveness of lifestyle medicine treatments. news release. Yurek Alert. March 28, 2024. Accessed March 29, 2024. https://www.eurekalert.org/news-releases/1039451

2. Kelly JH, Rihanoff L, Carlsen MC, et al. Performance measurement in lifestyle medicine: an expert consensus statement defining indicators to identify remission or long-term progression after lifestyle medicine treatment. AJLM. 2024.doi:https://doi.org/10.1177/1559827624123023