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Does health advice actually work?

New study explores the effectiveness of advising patients on lifestyle changes.

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Guidelines normally recommend that health professionals advise patients on behaviour changes, or lifestyle interventions. Lose weight, watch your diet, stop smoking, get some exercise. We’ve all heard these at some point in our lives. But how many of us really follow through with them?

Yes, er, no, doctor

A team of researchers led by the University of Gothenburg (UGOT) in Sweden questioned whether patients make any concrete changes to their lifestyle following such advice. They found no conclusive evidence that lifestyle counselling in medicine works after receiving it. The findings were published in the journal ‘Annals of Internal Medicine’. “There is often a lack of research showing that counseling patients is effective. It is likely that the advice rarely actually helps people,” commented study lead author Minna Johansson, associate professor at UGOT and general practitioner, in a news release. The study examined 379 medical recommendations from the United Kingdom’s National Institute for Health and Care Excellence. Of these, only 3 % showed that the recommended advice had a positive impact on behaviour based on scientific evidence. Another 13 % of this advice exhibited some evidence that the intervention was successful, but the certainty was low. The team also analysed additional guidelines from other major institutions worldwide. The results revealed that these guidelines usually overestimate the positive effect of the recommended lifestyle intervention and seldom consider the drawbacks. “Trying to improve public health by giving lifestyle advice to one person at a time is both expensive and ineffective,” explained Dr Johansson. “Resources would probably be better spent on community-based interventions that make it easier for all of us to live healthy lives.”

A guideline that matters

The researchers introduced a new guideline aimed at policymakers and those who inform guidelines. They suggest taking into account an intervention’s advantages and disadvantages before recommending it. “The guideline consists of a number of key questions, which show how to adequately evaluate the likelihood that the lifestyle intervention will lead to positive effects or not,” concluded co-author Victor Montori, professor of medicine at Mayo Clinic in the United States.

Keywords

lifestyle, lifestyle change, lifestyle intervention, health advice, advice, health professional, patient, guideline