A holistic health program that uses a team approach to caring for chronic disease patients who commit to lifestyle changes is expanding its reach to the Oakland area.
The Kaiser Permanente Health Achieved Through Lifestyle Transformation, or HALT, program, uses physicians, pharmacists, behavioral health specialists, and health educators to help patients with diabetes and heart disease live better, healthier lives. Rajiv Misquitta, MD, was the principal investigator for a 2-year clinical trial of the program. Robin Baltrushes, MD, a Kaiser Permanente Oakland family medicine physician, is now referring Oakland area patients to a virtual pilot of the HALT program hosted by the Kaiser Permanente South Sacramento Medical Center.
“One of our participants decreased her insulin use by half in the first 2 weeks,” said Dr. Baltrushes. “All our patients in this cohort share a strong motivation to minimize medications and are all willing to be on a whole food, plant-based diet to achieve this goal.”
Pilots of the program have also been implemented at Kaiser Permanente sites in Roseville and Walnut Creek, while similar lifestyle medicine programs are located in San Francisco, Fremont, San Rafael, and Santa Clara, said Dr. Baltrushes.
She and colleagues have enrolled 8 Oakland area patients in the 1-year virtual pilot that she hopes could expand to a new group of 10 to 20 patients enrolled each month in Oakland.
The multidisciplinary health team assigned to each patient meets each week to track progress. Patients are encouraged to change how they live through a plant-based diet that takes into account cultural and ethnic backgrounds, cooking classes to help people eat better, education around their disease, mindfulness, behavioral health support, and the importance of movement and exercise.
“The team is focused on how an individual can improve his or her life, not on a cookie cutter set of rules that everyone has to follow to get better.”
Dr. Baltrushes said data from the South Sacramento program shows reduced daily medications and patient blood pressure, and some patients who completely reverse their diabetes. Patients also lose weight, reduce cholesterol, have less body pain, and show an increase in physical abilities.
“The great thing about this is that the clinical team is focused on how an individual can improve his or her life, not on a cookie cutter set of rules that everyone has to follow to get better,” said Talya Marcus, senior consultant with Kaiser Permanente’s Patient Care Improvement System.
Dr. Baltrushes said the program can lower health care costs through reduced medication use and fewer hospitalizations.
“One of the goals is for patients to get off their medications,” she said. “I can get your test numbers to look good by putting you on a ton of medication, but how is that beneficial for the patient and their lifestyle?”
The program is not for all Kaiser Permanente members with coronary artery disease or diabetes, Marcus said. They are referred by a pharmacist or doctor and must score high on a “readiness to change” questionnaire.
“They have to be willing to make dramatic life changes,” Marcus added. “Our team of health care providers balances that out by considering their circumstances, and where they come from in their culture and communities, because everyone is different.”