Marian Joëls, UMCG Executive Board, and Chris Polman, Amsterdam UMC Executive Board, endorse the importance of lifestyle medicine. “As the board of directors of a teaching hospital, we think it is very important to pick up the gauntlet and investigate and implement the role of a healthy lifestyle in the treatment of lifestyle-related diseases. With that knowledge in our pocket, we are happy to work with other healthcare partners in the Netherlands towards broad implementation.”
Lifestyle changes are extremely difficult, but very important to prevent disease from worsening or relapse. It is difficult for many patients to break long-standing unhealthy habits. People often want to, but it doesn't work. Healthcare providers in the hospital do not have the time to discuss the importance of a healthy lifestyle in detail with the patient. That is why this LOFIT project, in which treating physicians refer patients to a lifestyle front office in the hospital. An employee of this lifestyle front office, the lifestyle broker, can discuss his motivation for a healthy lifestyle in detail with the patient. This can include lifestyle changes in the areas of daily exercise and sitting, a healthy diet, smoking cessation, the use of alcohol, how to deal with stress and ensuring adequate sleep.
“Awareness of an unhealthy lifestyle is important in order to achieve change. A lifestyle broker has the time and skill to help with this and to motivate people. The change to be made does not have to be complicated. Small daily, sustainable adjustments in health behaviour, such as taking a lunch walk or drinking tea without sugar, quickly have an effect, which only increases in the longer term,” says Judith Jelsma, project leader LOFIT and lifestyle coach at Amsterdam UMC.
The lifestyle broker consults with a motivated patient about suitable initiatives in his or her immediate living, residential and/or working environment. After all, it is precisely local initiatives that help patients to maintain a healthy lifestyle for a long time. The lifestyle broker keeps in touch with the patient about his progress and informs the attending physician about this. LOFIT thus forms a bridge between patient, hospital and the possibilities for a healthy lifestyle in the immediate vicinity of the patient.
The partners involved signaled the need for a new implementation model for lifestyle in healthcare. Rienk Dekker, professor of rehabilitation medicine and active lifestyle (UMCG) and Willem van Mechelen, professor of social medicine (Amsterdam UMC): “We have developed various effective interventions in the past, but it is difficult to implement these interventions in practice. The LOFIT lifestyle front office is a new implementation model for embedding lifestyle directly in the treatment of the patient”.
LOFIT is a follow-up to the previous program PIE=M, in which a lot of information was collected about prescribing Exercise as Medicine (beweegstappenplan.nl). LOFIT goes a step further by embedding a lifestyle front office in the patient's care path and by focusing on multiple unhealthy lifestyle behaviours. LOFIT consists of a consortium of academic hospitals, universities, health insurers Zilveren Kruis and Menzis, universities of applied sciences and partners who have contact with local 'healthy lifestyle initiatives' in the region.
Menzis and Zilveren Kruis are very pleased with this initiative: “More attention to a healthy lifestyle, strengthening of vitality and prevention are essential to keep healthcare in the Netherlands accessible and affordable. We are jointly responsible for this and we can only achieve this by working together. This initiative is a good example of this. Because even if you are sick and have to go to hospital for treatment, you can prevent worse and in some cases even reverse the disease by paying attention to your lifestyle and through prevention.” Suzanne Oostvogels, regional manager Care at Menzis.
The first year of this project is devoted to the development of the lifestyle front office. To this end, discussions are held with patients and care providers to find out experiences and needs. The (cost) effectiveness of the lifestyle front office will also be tested in two patient populations; patients with cardiovascular disease and patients with osteoarthritis. If LOFIT is effective, the intention is to scale up LOFIT within both academic hospitals. The duration of this project is until November 2024.