Q&A: New performance standards will assess effectiveness of lifestyle medicine

Key takeaways:

• Some measurements could become the standard of care in lifestyle medicine, an expert said.
• The measurements may also help compare lifestyle treatments with other therapies.

An expert panel released the first consensus statement on performance measures to identify remission and evaluate the effectiveness of lifestyle treatment medications.

“These new performance measures defined by the expert panel will help clinicians adopt evidence-based lifestyle medicine by equipping them with the standards they need to measure the success of those treatments,” American College of Lifestyle Medicine (ACLM) Founding President John H. Kelly, MD, MPH, DipABLM, FACLM, said in a press release.

According to the release, specific measurements were chosen to determine the efficacy of lifestyle medicine approaches to care. The measurements were grouped into 10 categories of diseases, conditions or risk factors, including:

• cardiac function;
• cardiac risk factors;
• cardiac medications and procedures;
• patient-centered cardiac health;
• hypertension;
• type 2 diabetes and prediabetes;
• metabolic syndrome;
• inflammatory conditions;
• inflammatory condition patient-centered measures (measures relevant to the patient experience); and
• chronic kidney disease.

In total, 32 performance measures achieved consensus.

Micaela C. Karlsen, PhD, MSPH, senior director of research at ACLM, spoke to Healio to discuss the need for a consensus statement on performance standards in lifestyle medicine, what impacts these standards may have on the field and more.

Healio: Why was there a need for these performance standards?

Karlsen: The field of lifestyle medicine is still relatively new. As we further grow in terms of clinical practice and research activity, it’s important that we have consensus within the field of what measures we’ll use to assess and track progress in terms of clinical outcomes for patients. There just wasn’t a set of standards like this that existed previously.

This consensus paper presents an organized, structured list of which measures the panel deemed most appropriate for assessing patient progress toward remission.

Healio: What impact will these measures ultimately have on lifestyle medicine?

Karlsen: We hope these will be more commonly used in visits recorded in electronic medical records and, therefore, eventually available for retrospective analyses or in prospective research. We would also like to see them become part of the standard of care in lifestyle treatment, incorporated into clinical care in a more consistent and standardized way.

We’d also like to eventually use these in eventual comparisons of lifestyle treatment with other procedures or pharmalogical treatments. It offers framework for making some of those assessments to see how effective lifestyle treatment really can be.

Healio: Can you give an example of a measurable performance standard for one of the conditions, like hypertension?

Karlsen: The measures for hypertension are very straightforward. It’s not like we strayed far from what’s already known and accepted in the field. The three measures for hypertension are systolic BP, diastolic BP and a reduction in need for medications or procedures with known effects on hypertension.

Healio: Where does work on the performance measures and expert consensus statement go from here?

Karlsen: We hope that they will be incorporated into our educational and training products for lifestyle medicine-certified practitioners... we hope that all clinicians will be familiar with them, will understand the value and how they fit together and will be more likely to use them in their practice.

Healio: Anything else to add?

Karlsen: You would never expect drug treatments to be adopted, paid for and widely used if there was no evidence that they work. It’s very intuitive that lifestyle treatment has a lot of benefits for patients that relate better health outcomes and quality of life. It’s kind of obvious that if you’re healthier, you’ll feel better and feel happier than if you’re sicker and have to take more medications or have more procedures. But we need to go further than “intuitive.”

We need to use rigor to measure and assess the outcomes that are possible with lifestyle treatment, and the more rigor we can add to our methodology and the clearer the standards we can set for clinicians in measuring their work and scientists in measuring effects in research, the better we’ll be able to talk about the benefits of lifestyle medicine and the more obvious and straightforward it will be discuss that in settings related to reimbursement, policy or clinical care standards.

References:

• First performance standards published to measure the effectiveness of lifestyle medicine treatments. https://www.prweb.com/releases/first-performance-standards-published-to-measure-the-effectiveness-of-lifestyle-medicine-treatments-302102774.html. Published March 28, 2024. Accessed April 2, 2024.
• Kelly J, et al. Am J Lifestyle Med. 2024;doi:10.1177/1559827624123023.