Healthcare providers are increasingly offering guidance to patients on improving their health, but often, there is insufficient scientific backing for whether this advice is truly effective. This insight comes from a study conducted by the University of Gothenburg, which also suggests ways to form more effective recommendations.
The researchers are not disputing the quality of the advice—such as losing weight, quitting smoking, adopting a healthier diet, or increasing physical activity. However, they found no substantial evidence that patients actually alter their lifestyles after receiving such guidance from their health providers.
“Research often lacks evidence proving that advising patients results in significant changes. It seems that this guidance rarely leads to real improvements,” notes Minna Johansson, an Associate Professor at Sahlgrenska Academy at the University of Gothenburg and a General Practitioner at Herrestad’s Healthcare Center in Uddevalla, who led the study.
Limited Evidence Supporting Recommendations
The study, which was published in the Annals of Internal Medicine, was carried out by a global team of researchers. They previously assessed medical recommendations from the UK’s National Institute for Health and Care Excellence (NICE), which has developed 379 pieces of advice and intervention strategies for healthcare professionals aimed at promoting lifestyle changes in patients.
The findings revealed that only 3% of these recommendations were backed by solid scientific evidence confirming their effectiveness in real-life situations. An additional 13% offered some form of evidence, but with low certainty. The team also explored guidelines from other prominent organizations worldwide and found that they frequently overstate the benefits of the recommendations while neglecting potential downsides.
“Efforts to enhance public health by providing lifestyle advice on an individual basis are both costly and largely ineffective. It might be more beneficial to invest in community-level initiatives that facilitate healthier living for everyone,” Minna Johansson adds, also highlighting that such advice can lead to increased stigmatization of individuals, particularly those with obesity.
Guiding Future Actions
Current healthcare professionals face challenges in delivering all the recommended advice while maintaining other aspects of care. The researchers estimated that, in the UK, an additional five times the current number of nurses would have to be hired to manage this workload effectively.
The study also introduces a new guideline designed to assist policymakers and guideline authors in systematically weighing the advantages and disadvantages of interventions before making recommendations. Victor Montori, a Professor of Medicine at the Mayo Clinic in the United States, co-authored the study: “This guideline comprises essential questions that help properly assess the likelihood of a lifestyle intervention leading to positive outcomes,” states Victor Montori.
