生活方式医学:在初级保健中提供生活方式医学干预的小组咨询方法

Q3 Medicine Lifestyle medicine (Hoboken, N.J.) Pub Date : 2021-01-12 DOI:10.1002/lim2.19
Caroline A. Gibson, Celia Mason, Clive J. Stones
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引用次数: 1

摘要

慢性病流行率的上升对卫生保健系统提出了更高的要求,需要以循证经济有效的方法来解决这些问题。该项目通过向慢性病高风险患者提供整体生活方式医学方案,试行了一种在一般实践中提供生活方式医学的新方法。方法11例慢性疾病高危患者参加了为期6周的全科医生(GP)小组会诊,提供循证生活方式教育和生活方式医学各支柱的干预措施。在项目开始和结束时评估人体测量数据(包括体重和身体质量指数(BMI))和生活质量数据(使用EuroQol-5D (EQ-5D-5L)工具)以及患者的信心和动机,以评估影响。通过计算EQ-5D-5L数据的每质量调整生命年成本(QALY)来估计成本效益。73%的参与者体重减轻,平均体重减轻1.7 kg,置信区间(CI)为-3.46至-0.02 kg;P = 0.048),结果平均BMI降低0.56 (CI, -1.11 ~ -0.02;P = 0.043)。生活质量评分有所改善,其中EuroQol-visual analogue scale (EQ-VAS)评分提高23分(CI, +11.82 ~ +34.18;P = 0.002), EQ-5D-5L评分显示行动障碍、焦虑、抑郁和疼痛有所减少。患者自我评价的信心和改变健康生活方式的动机在方案中显著改善。结论:通过gp主导的小组咨询模式提供生活方式药物干预可改善患者的健康和幸福感,同时减轻体重,减少情绪和疼痛问题。以这种方式提供护理具有成本效益。这项中试研究的积极结果支持了对更大规模研究的投资,以进一步开发和探索以这种方式提供生活方式药物干预。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Living Well with Lifestyle Medicine: A group consultation approach to delivering Lifestyle Medicine Intervention in Primary Care

Introduction

Increasing prevalence of chronic disease is raising demands on the healthcare system, and evidence-based cost-effective ways to address these are needed. This project piloted a novel approach of delivering lifestyle medicine in general practice by providing a holistic lifestyle medicine programme to patients at high risk of chronic diseases.

Methods

Eleven patients at high risk of chronic disease participated in a 6-week programme of General Practitioner (GP)-led group consultations, which delivered evidence-based lifestyle education and interventions across all the pillars of lifestyle medicine. Anthropometric data (including weight and body mass index (BMI)) and quality-of-life data (using the EuroQol-5D (EQ-5D-5L) tool) and patient's confidence and motivation were assessed at the beginning and end of the programme to assess impact. Cost-effectiveness was estimated by calculating the cost-per-quality-adjusted-life-year (QALY) for the EQ-5D-5L data.

Results

Seventy-three per cent of participants lost weight, with an average weight loss of 1.7 kg confidence interval (CI), –3.46 to –0.02 kg; P = 0.048), which resulted in an average BMI reduction of 0.56 (CI, –1.11 to –0.02; P = 0.043) over 6 weeks. Quality of Life scores show improvement, with EuroQol-visual analogue scale (EQ-VAS) score increase of 23 points (CI, +11.82 to +34.18; P = 0.002) and EQ-5D-5L scores show reduction in mobility problems, anxiety and depression and pain. Patient's self-rated confidence and motivation to make healthy lifestyle changes improved significantly over the programme.

Conclusions

Delivery of lifestyle medicine intervention via a GP-led group consultation model results in improvement in patients’ perceived health and well-being, along with reductions in weight, and reduced problems with mood and pain. Delivery of care in this way is cost-effective. The positive findings from this pilot-scale study support investment in a larger study to further develop and explore delivery of lifestyle medicine intervention in this way.

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CiteScore
2.10
自引率
0.00%
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0
审稿时长
7 weeks
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