Continuous Glucose Monitors and Programmed Shared Medical Appointments in Managing Type 2 Diabetes Mellitus Among First Nation Women in Australia: A Co-Designed Feasibility Study.

First Nations women in Australia diagnosed with type 2 diabetes, co-designed and attended a programmed shared medical appointment that included continuous glucose monitors and culturally responsive food appreciation activities over 8 weekly sessions to improve glycaemic control. The project was a single site, longitudinal change from baseline, mixed methods, feasibility study using HbA1c as the primary outcome measure. Secondary outcome measures included, weight, metabolic health-related blood panels, CGM, Blood Glucose Levels (BGL) time-in-range percentage, Patient Activation Measure (PAM) and Problem Areas In Diabetes (PAID) tools and client satisfaction survey and semi focussed interviews.

Re-imaging healthcare delivery in the era of COVID-19.

The COVID-19 pandemic has exposed the deficiencies of the current healthcare system in terms of a disconnect between primary and tertiary care and increasing subspecialisation, the focus on acute episodic care rather than on prevention in a time where chronic disease prevails and an inefficient use of healthcare resources. Herein, we present the case for an alternative model of healthcare delivery - shared medical appointments - which are efficient, effective and empowering and can be transitioned to the virtual environment successfully. We highlight the barriers to implementation and how these can be overcome.

Overweight and obesity management in musculo-skeletal primary care: a survey of Australian health practitioners exploring ‘the elephant in the room’.

Background: Overweight and obesity has a bi-directional association with the growing burden of musculoskeletal (MSk) dysfunction and pain. It seems inevitable that MSk practitioners will see increasing numbers of patients who are overweight and or obese and require this to be addressed as part of their management. Little evidence exists to describe the engagement of patients and their MSk practitioner in weight management as an adjunct or direct component of their intervention or therapy.

Adverse Childhood Experiences as "Upstream" Determinants of Lifestyle-Related Chronic Disease: A Scoping Perspective.

We have previously proposed a list of determinants (causes) of modern lifestyle-related chronic disorders, which provides a structure for the emerging discipline of lifestyle medicine. This consists of lifestyle factors with a common immune biomarker () that interact in a systems fashion linked with chronic disease outcomes. We considered this to be a work in progress and later added 3 psychosocial determinants into the causal mix: meaninglessness, alienation, and loss of culture and identity (MAL).

Shared Medical Appointments and Mindfulness for Type 2 Diabetes-A Mixed-Methods Feasibility Study.

Introduction: Type 2 diabetes (T2DM) is a major health concern with significant personal and healthcare system costs. There is growing interest in using shared medical appointments (SMAs) for management of T2DM. We hypothesize that adding mindfulness to SMAs may be beneficial.

Lifestyle Medicine in Australia: A Potted History-So Far.

Lifestyle medicine commenced in Australia in response to the rise in chronic diseases following the epidemiological transition that began in the 1980s. Today, it is flourishing with an annual conference, a variety of multidisciplinary members, and a developed pedagogy for the "art-science."

Psychosocial Determinants of Chronic Disease: Implications for Lifestyle Medicine.

We have previously identified a number of "determinants" of chronic disease, using the acronym NASTIE ODOURS. These have been given the collective term "anthropogens," in this journal and other publications, to help direct the management of modern chronic ailments to a monocausal focus, akin to that afforded infectious diseases by the "germ theory." We suggested the acronym NASTIE ODOURS as a starting point for a taxonomy of lifestyle medicine determinants.

Lifestyle medicine: The 'why', 'what' and 'how' of a developing discipline.

Background: Changes in living conditions throughout history typically result in changes in the pattern of diseases. The modern post-industrial era has resulted in a shift from predominantly infectious to predominantly chronic diseases, or those with a significant lifestyle/environmental aetiology. This has led to the development of an adjunct discipline of lifestyle medicine.

Programmed shared medical appointments for weight management in primary care: An exploratory study in translational research.

Background And Objectives: Programmed shared medical appointments (pSMAs) are an extension of shared medical appointments (SMAs) for managing chronic diseases. Acceptance and outcomes of a trial for weight management are reported here.

Method: Six programmed sessions in weight management were carried out in seven NSW primary healthcare centres.

PROCESS AND SYSTEMS: A systems approach to embedding group consultations in the NHS.

Group consultations are an important care option that is -starting to gain traction in the USA and Australia. This review summarises the likely benefits accruing from a systems -approach to implementing group consultations widely in the NHS and other socialised healthcare systems. Existing evidence is mapped to five distinct systems approaches: (1) development; (2) different age groups; (3) patient-centred pathway of care; (4) NHS system changes; and (5) education.

Programmed shared medical appointments: A novel procedure for chronic disease management.

Background: In 2013, the Australasian Society of Lifestyle Medicine (ASLM) introduced shared medical appointments (SMAs) for managing chronic disease in clinical practice. The popularity of SMAs has increased with the shift towards a Health Care Homes model. Programmed shared medical appointments (PSMAs) are an extension of the standard SMA model, designed to help manage more complex and specific chronic disease issues.

Establishing Proof of Concept for Clinical Processes in Lifestyle Medicine.

Lifestyle medicine is a relatively new discipline, designed to improve the management of lifestyle and environmentally induced chronic diseases. As such it is evolving new skills, tools, and procedures. But these are often not assessed for their potential before being adopted in practice.

A Review of Small Screen and Internet Technology-Induced Pathology as a Lifestyle Determinant of Health and Illness.

Most advances in humanity have been related to the discovery or introduction of new innovations and/or technology. There should be no suggestion that all technology is pathological or that major advances in health, science, and well-being have not come from industrial and technological advances. However, just like the invention of the wheel would have no doubt caused people to be injured and modern lifesaving medicines can have side effects, modern technology can have a downside, which needs to be recognized.

Shared Medical Appointments May Be Effective for Improving Clinical and Behavioral Outcomes in Type 2 Diabetes: A Narrative Review.

Type 2 diabetes mellitus (T2DM) is a complex chronic disease affecting over 400 million people worldwide. Managing T2DM and its associated complications in individual patient consultations poses substantial challenges to physicians due to limited time and resources and lack of access to multidisciplinary teams. Shared medical appointments (SMAs) are consecutive medical consultations provided by a physician in a group setting, where integrated medical care and patient education are delivered in a single session.

Healthy living.

Background: The nature of disease changes with the nature of societies. Modern chronic diseases that have superseded infections in the Anthropocene era, for example, have come largely from modern environments and lifestyles emanating from this. The concept of healthy living has subsequently changed accordingly.

Defining a Structure and Methodology for the Practice of Lifestyle Medicine.

Lifestyle medicine (LM) is a relatively new branch of clinical practice (like travel medicine, sports medicine, etc), but to date with little accepted structure or methodology. The current review extends a previous attempt to define the determinants of chronic disease by expanding this to include (1) the knowledge base (the science) or epidemiology of chronic disease, (2) the skills (the art) or practice of LM, (3) the tools (the materials) that can add to LM diagnoses and prescription, and (4) the procedures (the actions) that help update conventional medicine to include practices required for a new era of lifestyle and environmentally related chronic disease.

Shared medical appointments for Aboriginal and Torres Strait Islander men.

Background: Aboriginal and Torres Strait Islander health is generally the worst of any population group in Australia. Inaccessibility to health services is one possible cause of this. Shared medical appointments (SMAs) appear to be a culturally competent and appropriate way of improving access to, and the quality of, primary healthcare services for Aboriginal and Torres Strait Islander peoples.

Patients' and providers' satisfaction with shared medical appointments.

Background: Shared medical appointments (SMAs) are comprehensive medical visits conducted with groups of patients. We have previously discussed the potential and assessed likely support for SMAs in Australia. In this paper, we report on patient and provider satisfaction, and some subjective outcomes.

A user assessment of the potential for shared medical appointments in Australia.

Background: In some countries, shared medical appointments (SMAs) have been shown to be more effective than single consultations for managing chronic diseases. Our study was designed as the first stage of a Royal Australian College of General Practitioners (RACGP) funded project to assess potential patient and provider support for SMAs if they were to become available in Australia.

Methods: We conducted focus groups with healthcare providers and patients with diabetes in four large regional health centres in NSW.

Beyond obesity and lifestyle: a review of 21st century chronic disease determinants.

The obesity epidemic and associated chronic diseases are often attributed to modern lifestyles. The term "lifestyle" however, ignores broader social, economic, and environmental determinants while inadvertently "blaming the victim." Seen more eclectically, lifestyle encompasses distal, medial, and proximal determinants.