How doctors can help their patients make heart-healthy lifestyle changes

Lifestyle change is a powerful, proven way for a person to prevent heart disease. But to make healthy changes stick, people often need a little help.

初级保健医生可以提供至关重要的帮助，将患者与咨询联系起来，这已被证明是有效的. But because of time constraints or other barriers, those doctors often don't.

A new report offers guidance on how to change that.

这份科学声明周四发表在美国心脏协会杂志上 Circulation, summarizes research showing the benefits of behavioral counseling. 它还为忙碌的卫生保健专业人员提供了实用的方法来帮助患者获得这种护理——这种护理超出了典型的每年15分钟的预约.

Deepika Laddu, who led the group that wrote the statement, 他说，仅仅让病人意识到需要改变他们的饮食或运动习惯通常是不够的.

"It's one thing to say, 'I'm going to reduce the amount of fat in my diet.' But they need support to say, 'I'm going to maintain that as a lifestyle,'" said Laddu, 芝加哥伊利诺伊大学应用健康科学学院物理治疗助理教授.

这种支持可能包括对规划健康饮食或设定现实的锻炼目标的指导. 它还可以包括定期检查，以确保这些计划和目标在轨道上.

But "providers don't have time," Laddu said. "They may not have the resources in place. There also are system-related factors," such as the bureaucracies behind referral policies or reimbursement.

该报告通过总结在初级保健或社区环境中实施的项目的研究，阐明了克服这些障碍的重要性，这些项目已被证明对中年或老年人有效. “我们提供的是已经成功改善健康行为的最佳实践方法，而不是短期的, but for a long time," Laddu said.

One example is the Diabetes Prevention Program, said report co-author Dr. Jun Ma, a professor of medicine at the University of Illinois at Chicago. 这是一项经过充分研究的干预措施，其中包括定期与参与者会面的生活方式教练. 研究表明，在降低心脏病风险因素方面，它的效果与药物一样好，甚至更好.

但对于医生来说，开处方比让病人参加这样的项目要容易得多, Ma said. “他们没有相同的系统或基础设施来规定行为干预."

马说，不应该期望过度劳累的初级保健专业人员自己做所有的工作. “典型的临床医生没有接受过行为咨询师或健康教练的培训. So, it needs a team-based approach. 我们需要有经过行为咨询训练的人加入护理团队."

To help with that, 该报告为医生提供了社区项目列表的链接，这些项目可以通过疾病控制和预防中心获得, the YMCA and others – that they can use to refer patients. 它解释了项目如何符合《线上娱乐电子游戏网站》的保险范围.

Ma said even if a practice has not been making use of behavioral approaches, 这份声明是为了配合医生接受培训指导病人的方式而写的. So, 希望它能系统地使医生更容易帮助病人，并为那些需要的人安排护理.

鉴于人口老龄化和心脏病发病率上升的长期趋势，该报告是改变医生促进健康方式的一个起点, Laddu said.

“除非我们现在做出改变，否则我不知道我们的医疗保健系统是否有能力应对心脏病日益增加的负担," she said, “除非我们帮助提供者了解可用的工具，并提高他们在15分钟窗口之外可以做什么的意识。."

When a patient is ready for change, Laddu said, the health care team also needs to take accountability and say, "I need to help my patient change,无论是直接帮助病人，还是“安排支持系统，让病人得到他们需要的照顾。, when they need it, for as long as they need it."

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