Question about Lifestyle Modification Resources

[Aegis]

I've been in primary care for a few years now and it seems the evidence keeps rolling in for educating our patients on "lifestyle modifications" for a wide variety of chronic diseases. Like a lot research the evidence here is about as evident as saying the sky is blue. There is, and has been for quite some time the expectation that we as front-line providers are providing this to our patient population.

My frustration and observation over the years is that the information although vast, is scattered across the winds of the internet. I am considering building a database and working with other providers/disciplines to make a one-stop location that can provide resources to patients that would provide ideas for healthy diet, exercise, smoking cessation, etc. Physician built and managed. My question is, does anyone use anything or know of anything like this? I know we all have our go to resources we point patients to, but do any of you point your patients to user friendly location that has all of these resources and is evidence based? Do you think there is a need for such a thing?

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[simpler2]

I haven’t seen quality data change for my panel regardless of how much or what type of education I try to inpart so have moved towards focusing on this less and less. The problem with data to support lifestyle changes is that it comes from interventions that are very different than those that are practical/feasible with the current structure for primary care reimbursement. I don’t think any form of dispensed education can come close to such interventions.

 

[FrustratedFamDoc]

Unfortunately, most of my patients don't realize that "lifestyle modification" usually means doing something completely different than what they're currently doing. Education, unfortunately, rarely creates motivation. Motivation and attitude are truly the biggest barriers to positive change. Primary care docs are just a convenient scapegoat for our populations' poor health.

 

[deleted87716]

There's plenty of evidence and information out there already on lifestyle modification, or "TLC" (Therapeutic Lifestyle Changes). The real issues is motivation. IMO, training in motivational interviewing should be mandatory in med school and/or residency.

 

[AFMD]

Physicians really don't have a lot of time, I think the screening, brief intervention, and referral to treatment (SBIRT) framework is useful (usually associated with addiction screening/treatment, but works well with obesity as well). Very quick and universal screening for obesity/metabolic disease, brief intervention using the mental health technique of your choice (motivational interviewing as above is very popular for this), referring as necessary to behavioral health and specialist. You can manage it just like any other disease yourself if you like. If you don't, then the patient really does deserve a referral.

Being up to date on the intensive lifestyle change, medication, and surgery guidelines for obesity (you can simply follow UpToDate or the Obesity Medicine Association Obesity Algorithm). Almost always have the patient see some sort of mental health professional as well (just my opinion). See the patient frequently. It's all very doable. It's currently the standard, and soon I think it'll be much more common as younger physicians with more education on obesity and lifestyle change start entering the workforce.

I think that every primary care physician should be very comfortable with behavior change, it is unquestionably at the heart of chronic disease, and really the most effective way to help most people in an outpatient setting. I don't think you can be an expert in primary care without being an expert in behavior change.