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Lifestyle Medicine Education Essential for Improving Physicians’ Contribution to Disease Prevention

A healthy lifestyle is fundamental for the prevention and treatment of cardiovascular disease and other noncommunicable diseases (NCDs). The World Health Organization estimates that about 80 percent of NCDs could be prevented if four key lifestyle practices were followed: a healthy diet, being physically active, avoidance of tobacco, and alcohol intake in moderation.

Physicians are uniquely positioned to encourage individuals to adopt healthy lifestyle behaviors, however data indicates that lifestyle counseling does not routinely occur in physicians' offices in large part because medical education in the lifestyle and behavioral counseling domains is marginal compared with the time and resources devoted to pharmacological treatment. According to the American Medical Association (AMA) an average of only 23 hours of traditional 4-year medical school curricula is dedicated to prevention or health maintenance. As a result, physicians often report feeling ill prepared and lacking the confidence necessary to provide adequate lifestyle counseling and generally skeptical that their patients will be receptive to such advice.

A scientific statement from the American Heart Association (AHA) published in Circulation advocates for improved lifestyle counseling competency among future physicians by integrating key learning objectives into medical education and training. The authors contend that medical schools, by embracing healthy lifestyle promotion, counseling, and follow-up as part of required training, have the potential to lead a critically-needed paradigm shift in public health.

The emergence of new postgraduate residencies, fellowships and continuing medical education are contributing to the adoption of lifestyle medicine and reducing knowledge gaps of training and practicing physicians. The American College of Preventive Medicine’s 30-hour comprehensive Lifestyle Medicine Core Competencies Program is specifically mentioned by the authors in their review of previous recommendations and successful deployments of educational content on lifestyle counseling, health maintenance, and the prevention of NCDs.

To equip all future physicians with the knowledge and skills necessary to play a vital role in the prevention and treatment of cardiovascular disease and other medical conditions, the statement outlines a general framework for the design of a comprehensive education program that addresses the following components:

  • Behavioral sciences
  • Nutrition
  • Physical activity
  • Smoking
  • Other behaviors (including sleep, stress management, and alcohol consumption)
  • Varied learning formats
  • Patient-centered perspectives

The authors conclude that adequate training of physicians in lifestyle counseling is essential for the prevention and treatment of cardiovascular disease and other NCDs, and recommend that physicians become comfortable with engaging in conversations with their patients to initiate the behavior modification process, to make assessments, provide basic advice, and encouragement toward a healthy lifestyle, and to refer patients to other healthcare professionals in the appropriate situations.

The scientific statement published in Circulation (2016;134:00-00.) was approved by the AHA Science Advisory and Coordinating Committee and the AHA Executive Committee, and an expert peer review was conducted by the AHA Office of Science Operations.

REFERENCE

Hivert M-F, Arena R, Forman DE, Kris-Etherton PM, McBride PE, Pate RR, Spring B, Trilk J, Van Horn LV, Kraus WE; on behalf of the American Heart Association Physical Activity Committee of the Council on Lifestyle and Cardiometabolic Health; the Behavior Change Committee, a joint committee of the Council on Lifestyle and Cardiometabolic Health and the Council on Epidemiology and Prevention; the Exercise, Cardiac Rehabilitation, and Secondary Prevention Committee of the Council on Clinical Cardiology; and the Council on Cardiovascular and Stroke Nursing. Medical training to achieve competency in lifestyle counseling: an essential foundation for prevention and treatment of cardiovascular diseases and other chronic medical conditions: a scientific statement from the American Heart Association. Circulation. 2016;134:00–00. Link.

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SUMMARIES

A scientific statement from the American Heart Association (AHA) published in Circulation advocates for improved lifestyle counseling competency among future physicians by integrating key learning objectives into medical education and training. The authors contend that medical schools, by embracing healthy lifestyle promotion, counseling, and follow-up as part of required training, have the potential to lead a critically-needed paradigm shift in public health. http://www.acpm.org/page/ahalmstatement

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