Lifestyle Recommendations in the Dutch Clinical Practice Guidelines

Introduction:

Medical specialists play an essential role in guiding lifestyle changes in chronically ill patients, contributing to health-related prevention. Clinical practice guidelines (CPGs) are an important tool to support medical specialists to implement health-related prevention in daily practice. However, it remains unclear how recommendations on lifestyle interventions are part of CPGs. Therefore, the objective of this study was to analyse existing lifestyle recommendations in Dutch CPGs for medical specialists.

Methods:

Using a mixed-methods approach, the study examined 130 CPGs to assess the prevalence, type of lifestyle factors being addressed, level of evidence according to GRADE, knowledge gaps and wording of lifestyle recommendations.

Results:

Results indicated that 65% of the examined CPGs included lifestyle recommendations, with increasing physical activity and improving nutrition being the most addressed factors. Despite only 11% of the recommendations being supported by moderate to high certainty of evidence, 62% were strongly formulated. At the same time, the analysis also revealed unclarity in the wording of recommendations regarding who, what and when to act. Finally, this study shows notable knowledge gaps regarding the effectiveness and feasibility of lifestyle interventions in daily practice.

Discussion:

Despite robust evidence, lifestyle recommendations do have a prominent position in CPGs for chronic diseases in specialist' care. Further research is needed to answer to the knowledge gaps and to what is needed for lifestyle recommendations to be implemented in daily practice.