Nutritional and smoking advice recalled by patients attending a UK age-related macular degeneration clinic

Bott, Deborah A.; Huntjens, Byki; Binns, Alison

doi:10.1093/pubmed/fdx115

Cited by 8 publications

(15 citation statements)

References 29 publications

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“…13,[30][31][32] Of concern, a recent British study reported that only 53.1% of smokers with AMD recalled that they were advised to quit smoking by their ophthalmologist or optometrist. 33 The adjusted mean visual acuity improvement at 12 months was significantly different among the three groups. Nonsmokers had more than twice the gain in visual acuity after 12 months than smokers.…”

Section: Discussionmentioning

confidence: 83%

Smoking Status and Treatment Outcomes of Vascular Endothelial Growth Factor Inhibitors for Neovascular Age-Related Macular Degeneration

Vittorio

Nguyen

Barthelmes

et al. 2019

Retina

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PURPOSE To assess whether smoking status affects 1-year visual outcomes in eyes treated with vascular endothelial growth factor inhibitors for neovascular age-related macular degeneration. METH-ODS Retrospective analysis of data from a prospectively designed, multicenter, observational database. Nine hundred and eighty seven treatment-naive eyes of patients with neovascular age-related macular degeneration were tracked by the Fight Retinal Blindness! outcome registry in Australia, New Zealand, Singapore, and Switzerland who had documented smoking status at baseline and commenced vascular endothelial growth factor inhibitor therapy from January 2006 to December 2016. Generalized additive models were used to display visual acuity results. RESULTS There was a significant difference in mean improvement in visual acuity at 12 months between nonsmokers, ex-smokers, and current smokers (7.7 vs. 6.1 vs. 3.5 letters of change; P = 0.046) among patients who completed 12 months of treatment when adjusted for age, baseline visual acuity, and choroidal neovascular membrane lesion type and nested for practice. There was no significant difference in the median number of injections over 12 months of treatment by smoking status. Current smokers were a mean of 6.2 years younger than nonsmokers when they started treatment (P < 0.001). CONCLUSION This study found inferior 12-month visual outcomes in patients who continued to smoke while receiving vascular endothelial growth factor inhibitor therapy for neovascular age-related macular degeneration.

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Section: Discussionmentioning

confidence: 83%

Smoking Status and Treatment Outcomes of Vascular Endothelial Growth Factor Inhibitors for Neovascular Age-Related Macular Degeneration

Vittorio

Nguyen

Barthelmes

et al. 2019

Retina

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“…Alarmingly, among those with arthritis and overweight or obesity, approximately 75% of adults with overweight and 50% of those with moderate obesity (BMI 30 to < 35) are not receiving any provider weight-loss counseling [65]. The Royal College of Ophthalmologists maintains specific lifestyle counseling criterion for age-related macular degeneration, yet patients report that physicians rarely discuss the major portions of the guidelines [66]. Evidence also indicates that whether or not a physician engages in lifestyle guidance is a product of their own belief systems; that is, regardless of existing evidence supporting the importance of lifestyle, if a physician maintains the belief that lifestyle will not affect outcomes, they are unlikely to engage in such counseling [67].…”

Section: Nutrition Lifestyle Trainingmentioning

confidence: 99%

Golden Age of Medicine 2.0: Lifestyle Medicine and Planetary Health Prioritized

Logan¹,

Prescott²,

Katz³

2019

J Lifestyle Med

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The 'golden age of medicine'-the first half of the 20th century, reaching its zenith with Jonas Salk's 1955 polio vaccine-was a time of profound advances in surgical techniques, immunization, drug discovery, and the control of infectious disease; however, when the burden of disease shifted to lifestyle-driven, chronic, non-communicable diseases, the golden era slipped away. Although modifiable lifestyle practices now account for some 80% of premature mortality, medicine remains loathe to embrace lifestyle interventions as medicine Here, we argue that a 21st century golden age of medicine can be realized; the path to this era requires a transformation of medical school recruitment and training in ways that prioritize a broad view of lifestyle medicine. Moving beyond the basic principles of modifiable lifestyle practices as therapeutic interventions, each person/community should be viewed as a biological manifestation of accumulated experiences (and choices) made within the dynamic social, political, economic and cultural ecosystems that comprise their total life history. This requires an understanding that powerful forces operate within these ecosystems; marketing and neoliberal forces push an exclusive 'personal responsibility' view of health-blaming the individual, and deflecting from the large-scale influences that maintain health inequalities and threaten planetary health. The latter term denotes the interconnections between the sustainable vitality of person and place at all scales. We emphasize that barriers to planetary health and the clinical application of lifestyle medicine-including authoritarianism and social dominance orientation-are maintaining an unhealthy status quo.

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“…In age-related macular degeneration, specific guidelines have been crafted by the Royal College of Ophthalmologists concerning smoking cessation, as well as diet and nutritional supplement advice to be given to all patients. However, a recent post-visit study of patients shows that very few recommendations were made by physicians on these three matters [78].…”

Section: Lifestyle In Training and Practicementioning

confidence: 99%

From Authoritarianism to Advocacy: Lifestyle-Driven, Socially-Transmitted Conditions Require a Transformation in Medical Training and Practice

Prescott

Logan²

2018

Challenges

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The epidemic of socially-rooted, lifestyle-driven non-communicable diseases (NCDs; also referred to as socially-transmitted conditions) has now overtaken infectious diseases as the leading cause of human mortality. Despite this reality, physician education, training and practice within industrialized nations is heavily slanted toward the biopharmaceutical (and away from the psychosocial) aspects of prevention and treatment. As we underscore, the current state of physician training and practical application of guidelines pertaining to lifestyle is paltry and untenable. However, the solution is not a few more hours of nutritional biochemistry to check off the curricula box. Physician readiness for the current NCD crisis will require a philosophical shift in medicine-at-large, including candidate pooling. Recent elections in the United States and Europe have cast a spotlight on the public health consequences of political authoritarianism. However, we highlight that authoritarianism-and its related facets of social dominance orientation and Machiavellianism-are not exclusive to political candidates. Here, we open a dialogue on authoritarianism in westernized medicine as a starting point in order to encourage the development of critical research and to explore its potential as a barrier to patient care. We suggest that authoritarianism and its prejudices act as a border wall to the World Health Organization's broad vision of global health, cultural competency and patient autonomy. Moreover, the evidence reviewed here would suggest that in the context of the NCDs crisis, westernized medicine is long overdue a Flexner Report for the 21st Century.

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Nutritional and smoking advice recalled by patients attending a UK age-related macular degeneration clinic

Abstract: The findings suggest that it would be beneficial to review the provision of lifestyle advice to patients attending AMD outpatients' clinics, and to consider whether advice is being provided in an optimal format for later recall.

Cited by 8 publications

References 29 publications

Smoking Status and Treatment Outcomes of Vascular Endothelial Growth Factor Inhibitors for Neovascular Age-Related Macular Degeneration

Smoking Status and Treatment Outcomes of Vascular Endothelial Growth Factor Inhibitors for Neovascular Age-Related Macular Degeneration

Golden Age of Medicine 2.0: Lifestyle Medicine and Planetary Health Prioritized

From Authoritarianism to Advocacy: Lifestyle-Driven, Socially-Transmitted Conditions Require a Transformation in Medical Training and Practice

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