Assessment of observe and obstacles to way of life drugs amongst physicians in Saudi Arabia—A cross-sectional research

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ABSTRACT

Background:

Lifestyle drugs (LM) is an evidence-based method for stopping, treating, and probably reversing continual illnesses. Despite its advantages, little is understood concerning the extent of LM observe and perceived obstacles amongst physicians, significantly concerning coaching, sources, and institutional help.

Objectives:

To assess LM practices amongst main healthcare physicians in Saudi Arabia, establish obstacles to adoption, and decide the affect of demographic elements (age, gender, nationality, and prior LM studying expertise) on observe.

Methods:

A cross-sectional survey was performed amongst physicians in main healthcare facilities and pressing care providers throughout Saudi Arabia utilizing a self-administered, validated questionnaire. Three domains have been assessed: frequency of counseling, confidence, and precise LM observe. Barriers to implementation have been additionally explored. Data have been analyzed utilizing descriptive statistics, t-tests, ANOVA, and correlation analyses.

Results:

Of 400 invited physicians, 115 participated (29% response fee). Family physicians represented 51% of respondents; 56.5% reported receiving LM coaching. The imply confidence rating (M = 3.70 ± 0.86) was considerably increased than each counseling frequency (M = 3.57 ± 0.86) and precise observe (M = 3.55 ± 0.96; P < 0.027). Prior LM coaching and non-Saudi physicians reported increased observe scores. Strong correlations have been noticed between confidence and counseling frequency (r = 0.59-0.71, P < 0.001). Reported obstacles included time constraints, lack of supportive providers, with insufficient sources considerably predicting decrease observe (P = 0.012).

Conclusion:

Physicians display average engagement in LM, with obstacles to observe. This requires structured coaching, curricular integration, and institutional reforms to make sure enough sources, incentives, and multidisciplinary help.

Keywords: Barriers, way of life drugs, physicians, observe, main well being care, Saudi Arabia

Introduction

Lifestyle drugs (LM) was initially outlined by Katz D.L., as the usage of behavioral modifications in food regimen, train, sleep, stress, or substance use and/or publicity to stop, deal with, and probably reverse lifestyle-related, continual illness.[1] The newest definition offered by the American College of Lifestyle Medicine (ACLM) is “the use of a whole food, plant-predominant dietary lifestyle, regular physical activity, restorative sleep, stress management, avoidance of risky substances and positive social connection as a primary therapeutic modality for treatment and reversal of chronic disease.”[1] Also, the British Society of Lifestyle Medicine (BSLM) defines LM as “Evidence-based healthcare that supports behavior change through person-centered techniques to improve mental well-being, healthy relationships, physical activity, healthy eating, sleep, and minimization of harmful substances or behaviors.”[2]

In Saudi Arabia, the direct healthcare expenditure attributed to 10 main noncommunicable illnesses (NCDs) is estimated at roughly $11.8 billion yearly, representing round 13.6% of complete well being spending. The related productiveness losses are significantly increased, reaching practically $75.7 billion per 12 months, equal to about 4.5% of the nationwide GDP. According to UNDP estimates, cardiovascular illnesses alone account for roughly SAR 52 billion yearly, representing 57% of the whole financial burden of NCDs. Evidence signifies that way of life drugs (LM) interventions play a essential position in mitigating dangers of diabetes, heart problems, and weight problems, thereby providing potential financial and well being system advantages.[3] A variety of systematic critiques and research discover cost-effective outcomes versus ordinary care in relation to bodily exercise prescription and referral providers, particularly when focusing on higher-risk teams.[4]

Recent research advisable the pressing have to create alternatives to enhance physicians competencies in LM and to incorporate this in each undergraduate and postgraduate packages.[5,6]

Nutrition schooling is without doubt one of the six topics of LM. A latest evaluation on doctor’s information and observe of vitamin schooling in SA concluded that vitamin education schemes have been insufficient and low confidence of medical college students in offering dietary counseling to sufferers. Therefore, it’s important for intern and first care physicians to reinforce their medical vitamin information. Strengthening their understanding and expertise in vitamin will allow them to supply applicable dietary suggestions and successfully help sufferers in bettering their consuming habits and total well being.[7] However, main healthcare practitioners in Qatar reported a 58% counseling fee of vitamin and weight administration.[8] This signifies variation in LM observe throughout completely different nations inside the area.

The goal of the research is to establish current observe amongst main healthcare physicians in way of life drugs observe. Also, to establish particular person, system, and affected person obstacles affecting the adoption of way of life drugs by main care physicians. Moreover, to find out the affect of demographic elements comparable to age, gender, nationality, and former LM studying expertise on the present observe.

Methods

Study design and setting

A cross-sectional research to evaluate observe and obstacles to way of life drugs amongst physicians in Saudi Arabia. The research is to be carried out in main healthcare facilities, PHCs, and/or pressing care throughout geographic areas inside SA. The research occurred by means of each on-line invites and/or face-to-face invitation issued to illegible practising physicians from [16/05/2025] to [12/8/2025].

Study inhabitants and sampling

The goal inhabitants included licensed physicians practising in governmental PHCs and/or pressing care, navy, and personal sectors. Inclusion standards consisted of physicians with a minimum of six months of medical expertise, whereas these on prolonged go away or unwilling to take part have been excluded. A handy sampling method throughout varied observe inside PHCs was noticed. For the required pattern dimension, based mostly on reported counseling observe in earlier research solely 40% of physicians discuss way of life points in affected person counseling.[9] The calculated pattern dimension at 95% confidence was 369 physicians. The following equation was used to calculate the estimated pattern dimension.

n = [DEFF*Np(1-p)]/[(d2/Z21-α/2*(N-1)+p*(1-p)]

Data Collection Tool: A structured, self-administered validated two-questionnaire adopted from a research performed in Riyadh, KSA to evaluate KAP in way of life drugs.[10]

The questionnaire within the present research is titled “Assessment of Lifestyle medicine practice and barriers among primary healthcare physicians in Saudi Arabia.” The principal part of the questionnaire is as follows:

Demographic Information: Age, gender, nationality, years of observe, area of observe, Highest attained schooling, job title, continual illness standing, smoking, BMI, years of medical observe, specialty, historical past of coaching in way of life drugs.

Three domains on practising LM: The questionnaire comprised three domains—(1) Talking with affected person about way of life drugs, (2) confidence in discussing way of life drugs, and (3) precise observe of way of life drugs—every containing 9 objects. Responses have been captured on a Likert-type scale from 1 (by no means) to five (Always). Domains and the included objects have been adopted from the 27 observe objects initially validated and revealed by Alzaben. et al.[10]

Data preparation and reliability testing: Item responses have been inspected for completeness and vary. Internal consistency was evaluated utilizing Cronbach’s alpha (α). The calculated Cronbach’s alpha for the three domains was 0.880, 0.891, and 0.920, respectively, indicating that inner consistency was wonderful throughout the questions inside the domains.

Barriers to LM: Eight questions with sure or no responses. Questions have been developed on the potential obstacles encountered throughout affected person visits.

Data Collection Procedure: Physicians have been invited by means of in-person invitation and/or by web-based invitation. Participants have been supplied with details about the research’s function, and knowledgeable consent was offered earlier than participation. The questionnaire is to be accomplished anonymously on-line, to make sure confidentiality and voluntary participation.

Data Analysis and statistics: IBM SPSS model 16 for statistical evaluation. Descriptive statistics (frequencies, means, customary deviations) have been used to summarize demographic traits. The recognized principal consequence variables included the composite variables, comparable to common precise observe of LM, common speaking with affected person about LM, and common confidence in discussing LM. The secondary consequence variables included the principle reported obstacles to observe. The predictors included the sociodemographic variables, particularly (age, gender, nationality, area, sitting and space of observe, ever receiving coaching on LM)

Inferential statistics included ANOVA for steady variables to evaluate associations between the recognized three observe domains. A P worth < 0.05 thought-about statistically important.

Ethical issues

Ethical approval was obtained from the University of Jeddah Bioethics committee registration quantity HAP-02-J-094 and utility quantity UJ-REC-331 dated 16/3/2025. The mission full title “Assessment of lifestyle medicines knowledge, attitude and practice among primary healthcare physicians in Saudi Arabia” All procedures adopted the moral requirements of the Declaration of Helsinki. Participation was voluntary, and confidentiality of responses have been strictly maintained.

Results

Table 1 describes the sociodemographic traits of the collaborating physicians.

Table 1.

Sociodemographic traits of the physicians (n=115)

Variable Frequency (%)
Age
 20-25 4 (3.5)
 26-30 35 (30.4)
 31-35 30 (26)
 36-40 20 (17.4)
 41-45 15 (13)
 ≥46 11 (9.6)
Gender
 Male 55 (47.8)
 Female 60 (52.2)
Nationality
 Saudi 87 (75.7)
 Non-Saudi 28 (24.3)
Region of observe
 Central 18 (15.7)
 Eastern 47 (40.9)
 Western 40 (34.8)
 Northern 5 (4.3)
 Southern 5 (4.3)
Sector of medical observe
 Health cluster 74 (64.3)
 Military-based observe 15 (13)
 Private sector 18 (15.7)
 University-based observe 8 (7)
Years of medical observe
 <1 Y 3 (2.6)
 1-5 53 (46.1)
 6-10 27 (23.5)
 11-15 11 (9.6)
 16-20 14 (12.2)
 21-25 5 (4.3)
 ≥26 2 (1.7)
Physician specialty
 General observe 27 (23.5)
 Family drugs 59 (51.3)
 Preventive drugs 9 (7.9)
 Internal drugs 6 (5.2)
 Other specialties 14 (12.1)
Ever obtained coaching on LM
 Yes 65 (56.5)
 No 50 (43.5)
Virtual medical observe
 Yes 69 (60)
 No 44 (38.3)
 NA 2 (1.7)

A complete of 400 invites have been despatched, solely 115 contributors accomplished the survey, akin to a response fee of 29%. The majority have been Saudi feminine physicians, and the best proportion have been aged between 26 and 35 years. More than 75% from the jap and western area inside the KSA. About 64% of the physicians are practising inside well being clusters throughout the 5 principal areas inside KSA. Family physicians shaped 51% of the pattern, adopted by physicians with common observe at 23.5%. More than half of the contributors reported ever receiving LM coaching. Among these, solely 19 (16.5%) reported receiving it by means of steady skilled growth and 34 (29.6%) had the coaching throughout residency coaching. Only 12 (10.4) discovered about LM in the course of the medical college.

The influence of sociodemographic elements on the common rating of actual observe

An independent-samples t-test was performed to check the common actual observe rating between Saudi and non-Saudi physicians. Saudi physicians (M = 3.41, SD = 0.99) reported considerably decrease rating in comparison with non-Saudi physicians (M = 3.94, SD = 0.77),

t (58) = -2.879, P = .006, 95% CI [-0.884, -0.159].

An independent-samples t-test was performed to check the common actual observe rating between those that had coaching and people who by no means had coaching on LM. Physicians with earlier coaching (M = 3.75, SD = 0.93) reported considerably increased rating in comparison with those that by no means had coaching (M = 3.27, SD = 0.95), t (58) = -2.733, P = .007, 95% CI [0.133, 0.839].

Neither doctor age nor gender was considerably related to a excessive common actual observe rating. Moreover, those that serve at digital clinics have been exhibiting a better imply of common actual observe rating (M = 3.31, SD = 0.905); nonetheless, the imply distinction between digital and face-to-face clinic was not important.

The correlation between the actual doctor observe, speaking, and confidence on LM subjects

A Pearson’s correlation was performed to look at the connection between weight administration, vitamin, bodily actions, smoking, alcohol management, sleep well being, emotional wellness, mindfulness, and well being and wellness as components of way of life drugs counseling subjects and two predictors: frequency of speaking and confidence in discussing the subjects. Results indicated a variable important optimistic correlation as proven in Table 2.

Table 2.

Correlation between the actual doctor observe, speaking, and confidence on LM topics

LM observe subject Frequency of speaking Confidence in discussing
Practice of weight administration r=0.61, *P<0.001 r=0.65, *P<0.001
Practice of vitamin r=0.62, *P<0.001 r=0.61, *P<0.001
Practice of bodily actions r=0.67, *P<0.001 r=0.61, *P<0.001
Practice of smoking cessation r=0.63, *P<0.001 r=0.66, *P<0.001
Practice of alcohol management r=0.68, *P<0.001 r=0.68, *P<0.001
Practice of sleep well being r=0.62, *P<0.001 r=0.68, *P<0.001
Practice of emotional wellness r=0.59, *P<0.001 r=0.64, *P<0.001
Practice of mindfulness r=0.71, *P<0.001 r=0.60, *P<0.001
Practice of well being and wellness r=0.71, *P<0.001 r=0.66, *P<0.001

Physicians reported the very best imply of composite rating in confidence, adopted by frequency of speaking, whereas the bottom imply rating was reported in precise observe [Table 3].

Table 3.

Means of composite scores for speaking, confidence, and precise observe

Composite scores throughout the three domains Mean (±SD) P
Average speaking with affected person about LM 3.57 (0.86) <0.027*
Average confidence in discussing LM 3.70 (0.86)
Average actual observe of LM 3.55 (0.96)

Since the three domains conceptually measure related assemble, repeated-measures ANOVA was used and revealed that physicians’ confidence in discussing way of life drugs was considerably larger than each precise observe and the frequency with which they talked to sufferers about it (P < 0.027). Pairwise comparisons: Confidence > Talking (P < 0.013), Talking > Practice (P < 0.024), Confidence > Practice (P < 0.024).

The reported obstacles to LM observe

Figure 1 demonstrates the highest listed seven obstacles to observe LM. The prime three tire recognized obstacles to observe LM have been scarcity of time, adopted by lack of help providers and the perceived patient-related poor compliance.

Figure 1.

Figure 1

Reported obstacles to observe LM amongst physicians in SA

Factors related to obstacles to actual observe

A Chi-square take a look at of independence was performed to look at the affiliation between physicians’ earlier coaching in way of life drugs and their notion of lack of incentives as a barrier to observe. The outcomes revealed a statistically important affiliation between earlier coaching and reporting lack of incentives P < 0.008. Physicians who had obtained earlier coaching have been considerably extra prone to report an absence of incentives as a barrier in comparison with these with out earlier coaching.

A Mann-Whitney U take a look at was performed to look at variations in common actual observe of way of life drugs counseling between physicians who reported varied forms of obstacles and people who didn’t report obstacles. Physicians who reported “Lack of resources and materials” Median = 52.35 had decrease observe scores than those that didn’t report the barrier Median = 68.59. The outcomes indicated a statistically important distinction in observe scores between the 2 teams, U = 1076.5, Z = -2.493, P < 0.012.

Regarding the opposite reported obstacles, particularly, scarcity of time, lack of incentives, weak information on LM, lack of remedy expertise on LM, perceived poor affected person compliance and lack of affected person motivation every of which weren’t exhibiting statistically important variations in observe scores between two teams of physicians after making use of Mann-Whitney U take a look at at (P < 0.41, P < 0.96, P < 0.809, P < 0.27, P < 0.7, and P < 0.87), respectively.

Discussion

Among physicians practising in numerous areas inside main healthcare and pressing care providers in Saudi Arabia, a powerful optimistic correlation was noticed between the frequency of discussing way of life drugs subjects and the precise implementation of way of life drugs counseling. Similarly, a powerful optimistic correlation was noticed between physicians’ confidence in discussing these subjects and their reported observe. The common actual observe rating was considerably the bottom when in comparison with frequency of discussing and confidence to debate subjects associated to LM.

About 57% of physicians reported receiving coaching in way of life drugs. Despite this, substantial proportion nonetheless understand their weak information (73%) and lack of remedy expertise in ML (76%). This would possibly point out that current coaching could also be inadequate in enhancing competence. The hole between coaching publicity and self-reported capacity suggests a necessity for more practical, hands-on, and steady coaching interventions to translate information into medical observe.

Future LM coaching packages ought to emphasize sensible workshops, case-based studying, and simulated affected person encounters slightly than relying solely on didactic classes.[11,12] Additionally, integrating LM into undergraduate and postgraduate curricula may guarantee earlier publicity and stronger competency growth.[9] Establishing structured persevering with skilled growth (CPD) pathways would assist physicians preserve up to date information and confidence all through their careers. Collaboration with nutritionists, physiotherapists, and behavioral specialists may additionally improve multidisciplinary help and scale back the hole between theoretical information and sensible implantation. Moreover, to develop customized remedy plans.[13,14]

Physicians with earlier coaching reported considerably increased common actual observe in comparison with those that by no means had coaching. The discovering highlights the optimistic influence of structured schooling on medical utility of LM ideas. The discovering is supported by a big US-based trial involving roughly 3,000 practitioners who accomplished a web-based LM course, these reported important enhancements in each information and confidence scores associated to LM observe.[15]

Non-Saudi physicians reported considerably increased common actual observe than Saudi physicians, which can replicate variations in undergraduate and postgraduate curricula, worldwide publicity, or institutional emphasis on LM. This discovering highlights the necessity to strengthen LM schooling inside Saudi medical colleges and persevering with schooling frameworks to bridge the noticed observe hole.[16,17,18]

Across all reported obstacles, an absence of sources and supplies was a major sturdy predictor to decrease common actual observe in our research. This underscores the significance of offering physicians with enough instruments, affected person schooling supplies, and institutional infrastructure to help LM counseling. Conversely, in one other research, US physicians recognized patient-related behavioral change challenges as the first barrier to practising way of life drugs, accounting for 89% of reported obstacles.[19] Additionally, physicians reported a comparatively low stage of consolation in addressing sleep well being, with solely 47% feeling assured on this space of observe.[19]

Our findings demonstrated a powerful optimistic correlation between the frequency of discussing these subjects and the precise observe of way of life drugs counseling. Similarly, a powerful optimistic correlation was noticed between physicians’ confidence in discussing these subjects and their reported observe, reinforcing the notion that each communication frequency and doctor self-efficacy are essential determinants of LM implementation in medical care.[17,18]

The reported important affiliation between earlier coaching expertise and the perceiving lack of incentives as a barrier suggests a training-practice hole. Physicians who’re educated in way of life drugs usually tend to acknowledge systemic shortcomings, such because the absence of economic incentives, insufficient help providers, and heavy medical workload, which restrict LM integration into Practice, that hinder its implementation. This could replicate a training-practice hole, the place enhanced information and expertise heighten consciousness of exterior obstacles comparable to insufficient monetary incentives or institutional help. Addressing these systemic obstacles by means of coverage reforms, workload redistribution, and incentive methods could due to this fact be as essential as coaching itself. Previous research help this interpretation, noting that coaching alone is inadequate with out parallel structural reforms to advertise the combination of LM into routine care.[20,21]

Across the three observe domains, the common actual observe scores have been the bottom, suggesting a spot between confidence and the actual medical implementation. The discovering is supported by the restricted time as probably the most steadily reported barrier by the collaborating physicians. Our findings are in settlement with earlier research, which have constantly recognized lack of time because the principal barrier to way of life drugs counseling, with between 45% and 73.3% of collaborating physicians reporting this constraint.[22]

Limitations

Despite efforts by means of each in-person and web-based invites, the response fee remained low. This development has been reported globally by Meyer VM et al., with surveys exhibiting decrease response charges amongst physicians, significantly when invites are despatched through the net.[23] Another limitation is attributed to comparatively small pattern dimension made it troublesome to use regression evaluation to regulate for attainable confounding elements. Also, self-reported observe could also be associated to social desirability bias and therefore, inflated reporting and over reporting of optimistic observe.

The reliance on self-reported knowledge is one other shortcoming, which is topic to recall bias and social desirability bias, probably main physicians to overestimate their precise observe of way of life drugs. In addition, the usage of a comfort sampling technique could restrict the generalizability of the findings to all physicians in Saudi Arabia, significantly these in rural or underrepresented areas.

Additionally, the cross-sectional design prevents evaluation of causality between doctor coaching, obstacles, and precise observe. Longitudinal research can be crucial to guage how coaching and systemic modifications affect LM observe over time. Finally, limitations made it troublesome to generalize the findings.

Strengths of the Study

This research is among the many first to evaluate way of life drugs practices and obstacles amongst physicians in Saudi Arabia, offering precious baseline knowledge for future analysis and coverage growth. The use of a validated questionnaire with sturdy inner consistency (Cronbach’s alpha values starting from 0.88 to 0.92) enhances the reliability of the findings.

Another power lies within the numerous pattern, which included physicians from completely different specialties, observe sectors (governmental, personal, and navy), and areas throughout Saudi Arabia. This variety improves the representativeness of the outcomes and highlights variation throughout demographic and observe elements.

Furthermore, the research provides sensible insights by figuring out particular obstacles (e.g., lack of sources, scarcity of time, and affected person noncompliance) that may be focused by policymakers and educators. By inspecting each doctor confidence and precise observe, the research additionally helps to uncover the training-practice hole, providing steerage for designing more practical coaching interventions and system-level reforms.

Recommendation: Confidence in discussing LM topics was straight associated to practising every of the identifies LM topics. To undertake extra culturally appropriate devices to evaluate the doctor competencies. As earlier critiques display self-efficacy’s significance in healthcare conduct, making it a powerful alternative for measuring confidence in way of life drugs counseling.[24] Also, Physician Teaching Self-Efficacy Questionnaire (PTSQ) could be utilized to evaluate confidence in instructing the sufferers inside medical settings.[25]

LM coaching packages want to maneuver past didactic instructing towards extra interactive, hands-on approaches, whereas additionally being embedded in undergraduate and postgraduate curricula. At the institutional stage, larger help is required by means of the availability of affected person schooling supplies, referral pathways, and guarded time for LM counseling. Policy reforms that deal with systemic obstacles, comparable to workload and lack of incentives, alongside fostering multidisciplinary collaboration, are equally important. Finally, future analysis utilizing longitudinal designs is advisable to guage the long-term influence of coaching and coverage interventions on each doctor observe and affected person outcomes.

Data availability assertion

The datasets generated and/or analyzed in the course of the present research can be found from the corresponding writer on affordable request in anonymized kind.

Conflicts of curiosity

There aren’t any conflicts of curiosity.

Acknowledgment

The authors want to categorical their honest gratitude to all of the physicians who generously participated on this analysis. Special thanks are additionally prolonged to Dr. Raghad Tareq, a medical scholar, for her precious help and devoted efforts in knowledge assortment.

Funding Statement

Nil.

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Associated Data

This part collects any knowledge citations, knowledge availability statements, or supplementary supplies included on this article.

Data Availability Statement

The datasets generated and/or analyzed in the course of the present research can be found from the corresponding writer on affordable request in anonymized kind.


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