Life Style Modification Program LMP
Evidence for Lifestyle Modification interventions The Finnish Diabetes Prevention Study achieved a 58 per cent relative risk reduction between the intervention and the control populations through a combined diet and exercise program. This involved relatively limited weight loss (about 5 kg). 1 1 Tuomilehto J, Lindstrom MS, Eriksson JG etc al. 2001, Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. New England Journal of Medicine, Vol. 344 (18) May 3:1343-50
Evidence for Lifestyle Modification interventions The American Diabetes Prevention Program tested both a lifestyle intervention and medication approach to reduce the development of diabetes. It found that the lifestyle modification program achieved a %58 reduction in the incidence of diabetes and this was more effective than the use of medication (only a 31% reduction). 2 2 Knowler WC, Barrett-Connor E, Fowler SE, et al Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine 2002, February 7;346(6):393-403.
AusDrisk Tool Nationally accredited tool Provides patient with an at risk score which indicates the chance of developing diabetes within 5 years
Less than 5 = Low risk For patients in the low risk category provide support with Lifescripts Approx one in every 100 people will develop diabetes 6-14 = Intermediate risk Utilise Lifescripts to manage risk factors and provide patient with information on community supports available to assist them. Use recalls to check patient progress Scored 6-8 approx 1 in every 50 people will develop diabetes Scores 9-14 approx 1 in every 20 will develop diabetes
15 or more = HIGH RISK Book the patient in with the GP to have testing to EXCLUDE diabetes If patient is not diabetic consider referral to a Lifestyle Modification Program If LMP is not an option utilise Lifescripts and recalls to monitor the patient. Does the patient have a chronic disease which lead to development of a care plan? Scores 15-19 1 in every 7 people will develop diabetes Scores 20 and above approx 1 in every 3 people will develop diabetes
The LMP Program Educates patients on the risks of diabetes and the relationship to lifestyle risk factors Importance of regular diabetes screening Nutrition advice and education Physical activity advice Behavioural strategies to support the adoption and maintenance of lifestyle change Smoking cessation and alcohol reduction advice if required Information about community resources relevant to sustaining lifestyle change
Lifestyle Modification Program Obtain patient consent Referral Complete referral form and fax to 0755992289 EPiC Health Solutions (referral can be downloaded from ( www.health.gov.au/epc Explain the one off $50 co payment Bill item 713 (not to be billed within 3 years of a 717 however ( LMP patient can still be referred to EPiC will contact patients to confirm their application/venue/times and dates for the program
Relationship between MBS items Eligible patients can also be referred through the Item 717 or the Aboriginal and Torres Strait Islander Health Check (Item 710). GP cannot conduct an item 713, if a previous 713 has been conducted within the previous 3 years. A person who has previously accessed a 45-49 year health check (item 717), can only become eligible for item 713 when 3 years have elapsed. A previous item 713 does not preclude an eligible person from accessing item 717 in relation to the risk of developing other chronic illnesses
Lifestyle Modification Program Team Diabetes Educator Robyn Hart Dietitian Marie-Claire O Shea Exercise Physiologist Claire Mcgeachy Registered Nurse Deleese Boyd
The age group 40 49 Typically busy people in the working age group with families to look after Time poor To suit their lifestyle needs we will offer the LMP via evening courses Motivation Our LMP will utilise a web program to encourage participants to continue to achieve their goals and maintain motivation even AFTER the program is completed.
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