Lifestyle Medicine featured in the Australian Journal of General Practice (AJGP)
The Australasian Society of Lifestyle Medicine (ASLM) is excited to share that Lifestyle Medicine has been featured in the October 2019 edition of the Australian Journal of General Practice (AJGP). Readership of the AJGP includes at least 20,000 GPs, general practice registrars, international medical graduates, primary care academics, and medical students.
Prof Garry Egger, who is known around the world as one of the pioneers of Lifestyle Medicine, coordinated the feature as the guest editor, contributing his own expert knowledge and research, as well as curated articles from other highly regarded health practitioners in the field of Lifestyle Medicine.
In Prof Egger’s editorial Development of a lifestyle medicine, he discusses the dramatic shift in health in Western societies from a predominance of acute, infectious diseases to a predominance of chronic, usually non-infectious diseases, and the role of Lifestyle Medicine in assisting conventional approaches to clinical care.
“We provide an overview of the current landscape of the science and art of lifestyle medicine and include several practitioners’ perspectives on individual components of the field”, writes Prof Egger. These individual components and the topics of the four featured articles include: Lifestyle Medicine ‘why’, what’ and how’; Mental Health; Health Coaching; and Shared Medical Appointments.
The four articles featured in the AJGP October issue are hightlighted below.
Lifestyle medicine – the ‘why’, ‘what’ and ‘how’ of a developing discipline by Prof Garry Egger
Prof Garry Egger explains the structure of the discipline of Lifestyle medicine and outlines the four areas in which lifestyle medicine can add to the principles of conventional medicine: the science (the epidemiology), the art (the skills), the materials (the tools) and the procedures (the actions).
He also provides a clear distinction between conventional medicine and lifestyle medicine, for example, in conventional medicine, treatment is usually short term, and the emphasis is on diagnosis and prescription, whereas in lifestyle medicine, the treatment is almost always long term, and the emphasis is on motivation and compliance.
The key points from the article are:
- Chronic diseases now predominate over infectious diseases in Western societies.
- Lifestyle medicine is an adjunct discipline designed to aid chronic disease management.
- Lifestyle medicine adds importantly to conventional medicine in four areas: 1) the science, 2) the art, 3) the tools and 4) the actions.
- Although lifestyle medicine is now recognised worldwide, it is still a work in progress.
Lifestyle interventions for mental health by Dr Sam Manger
In his article ‘Lifestyle interventions for mental health’, Dr Manger discusses how lifestyle-related factors such as nutrition, physical activity, sleep, and smoking, affect mental health, and introduces ways of improving adherence, such as health coaching, community engagement and providing a multidisciplinary approach. “Strong evidence shows that lifestyle interventions, such as nutrition, movement, sleep, stress management and substance cessation, are efficacious and cost-effective therapies that improve mental health, physical health and quality of life.”
Key points from Dr Manger’s article:
- Mental illness is the single most common reason for patient visits to a GP.
- Patients with severe mental illness have a 10–20-year life expectancy gap, primarily due to chronic physical disease.
- Evidence-based lifestyle interventions can be effective in the management of both mental illnesses and the physical chronic diseases highly prevalent in people with mental illness.
- Health coaching and increased lifestyle assessment may improve long-term adherence.
- A multidisciplinary team is required to comprehensively improve the lifestyle factors of a patient living with mental illness.
Health coaching as a lifestyle medicine process in primary care by Shivaun Conn and Sharon Curtain
This article provides insights into how to integrate health coaching into practice, such as: assessing readiness to change, finding out the reasons the patient wants to change, identifying any barriers that may exist, facilitating patient-centred goal setting, and advice for incorporating health coaching into primary care.
“Integrating health coaching into primary care can significantly improve patients’ physiological, behavioural, psychological and social outcomes, as well as lead to higher rates of satisfaction for both patient and clinician.”
Key points from the article:
- Chronic diseases call for different approaches to management at the clinical level.
- Health coaching is a relatively new approach to modifying behaviours associated with the development of ill health.
- Health coaching uses health behaviour change theories to build motivation and promote self-determination and self-efficacy.
- Health coaching acknowledges the patient’s stage of change and increases importance and confidence to increase readiness to change.
Programmed shared medical appointments for weight management in primary care: An exploratory study in translational research by Prof Garry Egger, A/Prof John Stevens, Nerida Volker, Sam Egger
Most treatments for chronic disease in conventional medicine involve a one-on-one medical consultation, or, group education without medical consultation. Shared medical appointments (SMAs) are ‘individual medical consultations carried out sequentially in a group of patients with similar concerns, with all listening and contributing’.
Programmed shared medical appointments or pSMAs (an extension of SMAs), could provide a platform for a range of interventions for chronic diseases and conditions.
pSMAs were trialled in NSW using six programmed sessions in weight management, with the aim of measuring the acceptability of pSMAs for best use in primary care.
Key points from the article:
- pSMAs are a popular, cost and time-effective adjunct to standard clinical management
- pSMAs were calculated to be four times more cost-effective and up to seven times more time effective than 1:1 consultations for weight loss.
- Participant advantages of SMAs include peer support and contribution of peers to the consultation, extra time with a more relaxed and focused physician, and the contribution of Allied health professionals (AHPs) to a consultation.
- Benefits for facilitators and doctors include reduction of repetition to patients, less pressure on the doctor, and, the doctor is focused on the participants rather than the computer screen (the facilitator records the patient notes).
About the authors
In addition to being one of the founders and a current board member of ASLM, Garry Egger is a Professor of Health and Human Sciences at Southern Cross University, and an Advisor to the World Health Organisation and Government and corporate bodies in chronic disease prevention. He is the author of 30 books (including five texts), over 160 peer-reviewed scientific and research articles and numerous popular media articles on health and fitness.
Dr Sam Manger is a General Practitioner/Family Physician, President of the Australasian Society of Lifestyle Medicine, Australian representative for the Lifestyle Medicine Global Alliance, host of “The GP Show” podcast, and a medical educator with James Cook University (JCU) and Generalist Medical Training (GMT). His passion for health has evolved into reflecting on how to change individual and social behaviour to lead to a more healthy, sustainable and ethical culture.
Shivaun Conn is an Accredited Practising Dietitian (APD), Accredited Nutritionist (AN) Health Coach, Certified Trainer & Assessor, Director of Discovery Health Coaching and Vice President of the Australasian Society of Lifestyle Medicine. Shivaun has worked for over 15 years as a dietitian, health coach and presenter.
Sharon Curtain is a Dietitian, Nutritionist, Health Coach, the Director of Campaign Healthy, an author and co-creator, and has 16 years’ experience in clinical and corporate nutrition. She is passionate about health and how the theory of nutrition translates into practice.
A/Prof John Stevens is a health sociologist and Associate Professor (Adj) in the School of Health and Human Sciences at Southern Cross University (SCU). John was a founding member of ASLM and has provided academic leadership to the movement. He is pioneering the use of Shared Medical Appointments as a procedure to help clinicians put evidence-based Lifestyle Medicine into practice. John has over 60 peer-reviewed publications, including books on dementia and obesity management and continues to explore the translation of science into meaningful and measurable health care.
Nerida Volker has 20 years’ experience as a dietitian and is the Industry Relationship Lead – Allied Health at TAFE NSW. Her past roles include Senior Lecturer in Nutrition and Dietetics at the University of Canberra, Cardiovascular Health Manager for the Heart Foundation and Professional Services Director for the Dietitians Association of Australia (DAA).
Sam Egger is the Biostatistician working in the Cancer Research Division for Cancer Council NSW.
