When I started my career in healthcare as a pharmaceutical rep 20+ years ago, I had the opportunity to promote several cardiovascular and diabetes medications. The drugs had been proven to demonstrate strong clinical outcomes through peer-reviewed research. I was proud to represent these brands as I fully understood the benefit for patients. Medications have their role, but my goal in this article is to highlight the synergistic benefit of lifestyle change when these drugs are prescribed.
As you would expect, there was significant training prior to having discussions with any healthcare provider (HCP) about a given product. I needed a comprehensive understanding of both package insert details for my drug as well as any other medicines in the class.
When comparing package inserts (PI), there was always one consistent phrase in each of their “Indications & Usage” sections:
“...as adjunct to diet and exercise”
My team and I were expected to include this language in discussions with an HCP whenever there was mention of the approved indications. Below are a few examples of how this phrase was used from actual package inserts:
- Product “X” …“indicated as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus”
- Product “Y” …“as an adjunct to diet to reduce low-density lipoprotein cholesterol (LDL-C)”
- Product “Z” … “is an inhibitor of HMG-CoA reductase (statin) indicated as an adjunct therapy to diet to:”
The definition of an adjunctive therapy is: A therapy given in addition to the main treatment to maximize its effectiveness. Therefore, when interpreting the indications listed above, the drug would be given as adjunct therapy to the main treatment: diet and/or exercise!
Food As Medicine…
There’s a good reason why diet and exercise are the primary treatment recommendations included in each of these medication inserts - IT WORKS! However, while I always included diet and exercise as part of the therapy, the emphasis was always on what the drug could do, while minimizing the value of nutrition and routine movement.
In 2018, I joined Pritikin ICR. Now, instead of selling the adjunct therapy (drug), I now promote the main treatment for cardiovascular disease, lifestyle change.
Pritikin ICR is one of only three programs approved by Medicare to offer Intensive Cardiac Rehabilitation (ICR) to individual hospitals and physician groups across the country.
And while the drugs I referenced earlier all had proven outcomes, Pritikin ICR does too!
100+ peer-reviewed studies published on the Pritikin program.
To be approved by CMS (Centers for Medicare & Medicaid Services), the Pritikin program had to show, in peer-reviewed research, significant improvement in one or more of the following areas:
- Reduce the need for coronary bypass surgery
- Slow disease progression
- Lower risk factors for coronary artery disease
Pritikin demonstrated improvement in ALL three!
In addition, the program also had to demonstrate through peer-reviewed research that it accomplished a statistically significant reduction in five or more of the following:
- Low-density Lipoprotein (LDL-c)
- Body Mass Index (BMI)
- Systolic Blood Pressure
- Diastolic Blood Pressure
- The need for cholesterol, blood pressure, and diabetes medications
AGAIN, Pritikin met ALL six!
In today’s culture, we understand the challenges of sticking to a nutritious eating plan and active lifestyle. It’s difficult when billions are spent to promote the next biggest burger, chicken sandwich, burrito, etc.… And while each new technology introduced promises to make our life “easier”, it also makes us more sedentary! Most Americans continue to become increasingly complacent when it comes to their lifestyle habits.
Unfortunately, it’s also difficult for Providers of lifestyle change programs to overcome patient complacency. It must feel like Groundhog Day talking about the importance of daily behaviors to patients who only want a pill. But the benefits are worth the effort. Medications manage the disease process, while lifestyle changes can reduce risk factors for many chronic diseases.
Selling Diet & Exercise…
Looking back, I wish I could’ve spent more time as a pharma rep talking about the importance of comprehensive care. The emphasis should have been on diet and exercise as the main treatment, with medications added to maximize the benefit of lifestyle change!
So today, I’m blessed to be a part of a company where, when asked “what do you sell?”, I can passionately say, lifestyle medicine focused on exercise, nutrition, and having a healthy mindset! And for HCPs who have given in to the complacency of patients, just know that your words still matter. I encourage you to continue to be the champion for lifestyle change! As we like to say here at Pritikin ICR, we don’t need to strive for perfection…and progress is still a step in the right direction!