A healthy lifestyle is crucial for patients under treatment in the hospital to prevent disease progression. Initiating behavioral change is challenging, but a disease diagnosis can serve as a ‘teachable moment’ to incorporate lifestyle changes. However, healthcare professionals' limited time and competing priorities often limit their ability to engage with patients on in-depth lifestyle changes. To address this gap, APH researcher Judith Jelsma founded LOFIT (Lifestyle front Office For Integrating lifestyle medicine in the Treatment of patients) to integrate lifestyle medicine into secondary and tertiary care through a lifestyle front office. Here, lifestyle professionals discuss challenging lifestyle issues with patients, such as daily physical activity, healthy eating, smoking cessation, alcohol intake, sleep and stress management, and refer them to community-based lifestyle initiatives for further support.

Impact on patients

Research has shown that healthy lifestyle choices, like regular physical activity and a balanced diet, can significantly reduce the risk of non-communicable diseases such as heart disease and diabetes. Integrating lifestyle into routine care can enhance patient outcomes and support long-term health. The lifestyle front office provides dedicated time where professionals with specialized knowledge and skills can offer personalized guidance to patients regarding lifestyle, considering also underlying factors like social conditions. “With the lifestyle front office, we significantly impact patients' lives by building motivation and referring to personalized lifestyle guidance in the community,” Judith explains. “This personalized care is the most important impact we can have as it directly benefits the patient.” A short video about the patient experience has been created by LOFIT, and it can be viewed via this link: LOFIT - Leefstijlloket - Patiëntervaring - YouTube.

Turning research into practice

By founding the lifestyle front office, Judith Jelsma emphasized the importance of translating lifestyle medicine research into practical application: "In the past, many of my research projects ended once the funding ran out, despite promising results. What's important to me now is that we make sure that the obtained knowledge during a project is actually implemented and further used in practice. For example in LOFIT, we have been focused from the start on (future) implementation as we wanted a sustainable solution to embed lifestyle medicine in the treatment of patients."

Growing a lifestyle medicine network

LOFIT has received significant interest from other hospitals and increased media coverage has amplified its impact, resulting in over 15 hospitals adopting similar lifestyle front office structures. "We received many questions about how to set up similar lifestyle front offices," Judith shared. "This led us to organize monthly information meetings where interested hospitals could learn from our experiences. We also established a working group with all the university medical centers to share insights and created a comprehensive guide for setting up lifestyle front offices." This initiative has evolved into a national network that facilitates the sharing of knowledge regarding lifestyle medicine. “This has enabled us to jointly apply for funding and set up nationwide initiatives, such as a recent funding for a national dataregister for lifestyle front offices and funding for a national learning collaborative regarding implemenation. We are now much further along in building a cohesive, collaborative network that supports widespread implementation," Judith added. Internally, a network of lifestyle medicine advocates was developed to make lifestyle medicine part of the strategic goals of the Amsterdam UMC and to incorporate lifestyle into the educational curriculum. This collaboration has led to the successful organization of three fully booked lifestyle medicine symposiums for VU medical students.

Funding challenges for lifestyle medicine

Judith explained that securing funding for lifestyle front offices has been more complex than anticipated. Judith and representatives from the UMC workgroup have engaged with various stakeholders, including procure departments, insurance companies, ZN, NZA, and the Zorginstituut, to arrange structural funding through basic insurance coverage. The current funding is fragmented and a more stable financial foundation is essential to also support quality assurance efforts. These efforts are resource-intensive but crucial for the long-term success and expansion of lifestyle medicine. ZonMw, LOFIT’s funder, has provided additional funding which is crucial for effective implementation and impact. Looking ahead, Judith hopes to secure sustainable funding and integrate lifestyle medicine into routine hospital care. "We're working on getting reimbursement for this type of care," she noted. "While we're still gathering data on the effectiveness of a lifestyle front office, lifestyle as treatment option is proven effective in the past and is already obtained in medical guidelines. We need to ensure these services are available and accessible to all patients, especially as healthcare demands rise.”

Do’s:

  • Dare to share your project ideas and talk to stakeholders – even without having effectiveness data
  • Share the task of making impact among your colleagues
  • Seek for internal assistance from specialized departments, such as communication department or the procure department

Don’ts:

  • Don’t only focus on the time your project has funding, but look ahead and consider future implementation