Patient recall of receiving lifestyle advice for overweight and hypertension from their General Practitioner

Queens University Belfast, UK.
BMC Family Practice (Impact Factor: 1.67). 02/2010; 11(1):8. DOI: 10.1186/1471-2296-11-8
Source: PubMed


Overweight, obesity and hypertension can be prevented through improvements in lifestyle including nutrition and physical activity. General practitioners (GPs) in Australia have access to over 90% of the population in the course of a year and therefore, the general practice setting may be ideal to assist patients with lifestyle change for weight management and hypertension. The present study aimed to determine the proportion of overweight/obese patients that recalled receiving advice by their GP to make lifestyle changes for weight loss. Recall of advice received by hypertensive patients to reduce salt intake was also measured.
A face to face survey was conducted on a representative sample (urban, suburban and rural) of South Australian residents. Respondents provided information on height and weight (self-report), whether they had received lifestyle advice from their GP for weight loss, and for those with self reported hypertension if they had received advice to reduce dietary salt.
The sample included 2947 South Australian adult residents (58% female; BMI (mean (SD)), 26.6 (5.3) kg/m2; age, 50.7 (18.0) years). Ninety-six percent had visited their GP in the past 12 months. Forty-one percent of males and 25% of females were overweight and 19% of males and 20% of females were obese. Twenty-seven percent of overweight/obese respondents reported receiving lifestyle advice for weight loss purposes. Of the 33% who reported they had hypertension, 34% reported receiving advice to reduce salt intake.
Less than 1/3 of overweight/obese patients reported that they had received lifestyle advice that could assist with weight loss from their GP. About a third of respondents with hypertension reported that they received advice to reduce salt intake. There are potentially missed opportunities in which GPs could provide re-enforcement of benefits of lifestyle changes with respect to weight and blood pressure control.

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Available from: Alison Booth
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    • "The Australian Medical Council (AMC) states that medical practitioners need to have appropriate knowledge and skills in identifying nutrition issues for patients in order to prevent and treat common chronic disease [4]. However, doctors around the world, including Australia, have been found to be ill-equipped to identify and appropriately manage nutrition-related issues of patients, whether inpatients or those living in residential care or the community [5] [6] [7]. The most common cause of insufficient nutrition practice that has been identified is lack of nutrition knowledge [3] [8] [9]. "
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    ABSTRACT: Nutrition knowledge, attitudes, and confidence were assessed in General Practice Registrars (GPRs) throughout Australia. Of approximately 6,000 GPRs invited to complete a nutrition survey, 93 respondents (2%) completed the online survey, with 89 (20 males, 69 females) providing demographic and educational information. Fifty-one percent had graduated from medical school within the last two years. From a list of 11 dietary strategies to reduce cardiovascular risk, respondents selected weight loss (84%), reducing saturated fats (90%), a maximum of two alcoholic drinks/day (82%), and increasing vegetables (83%) as " highly appropriate " strategies, with only 51% indicating that salt reduction was " highly appropriate. " Two-thirds of registrars felt " moderately " (51%) or " very " confident (16%) providing nutrition advice. Most of them (84%) recalled receiving information during training, but only 34% recalled having to demonstrate nutritional knowledge. The results indicate that this group of Australian GPRs understood most of the key dietary recommendations for reducing cardiovascular risk but lacked consensus regarding the recommendation to reduce salt intake and expressed mixed levels of confidence in providing nutritional advice. Appropriate nutrition education before and after graduation is recommended for GPRs to ensure the development of skills and confidence to support patients to make healthy dietary choices and help prevent chronic diseases.
    Full-text · Article · Aug 2015
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    • "However despite high levels of risk from overweight and obesity and physical inactivity, receipt of dietary advice (eat less fatty food, eat more fruit and vegetables) and physical activity advice was less frequently reported. Respondents in previous study of overweight and obese people in South Australia reported broadly similar frequency of lifestyle advice from their GPs [3]. "
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    ABSTRACT: Background Despite being at high risk, disadvantaged patients may be less likely to receive preventive care in general practice. This study aimed to explore self-reported preventive care received from general practitioners and the factors associated with this by healthy New South Wales (NSW) residents aged 45–74 years. Methods A self-completed questionnaire was sent to 100,000 NSW residents in the 45 and Up cohort study. There was a 60% response rate. After exclusions there were 39,964 participants aged 45–74 years who did not report cardiovascular disease or diabetes. Dichotomised outcome variables were participant report of having had a clinical assessment of their blood pressure (BP), blood cholesterol (BC) or blood glucose (BG), or received advice to eat less high fat food, eat more fruit and vegetables or be more physically active from their GP in the last 12 months. Independent variables included socio-demographic, lifestyle risk factors, health status, access to health care and confidence in self-management. Results Most respondents reported having had their BP (90.6%), BC (73.9%) or BG (69.4%) assessed. Fewer reported being given health advice to (a)eat less high fat food (26.6%), (b) eat more fruit and vegetables (15.5%) or (c) do more physical activity (19.9%). The patterns of association were consistent with recognised need: participants who were older, less well educated or overweight were more likely to report clinical assessments; participants who were overseas born, of lower educational attainment, less confident in their own self-management, reported insufficient physical activity or were overweight were more likely to report receiving advice. However current smokers were less likely to report clinical assessments; and rural and older participants were less likely to receive diet or physical activity advice. Conclusions This study demonstrated a gap between reported clinical assessments and preventive advice. There was evidence for inverse care for rural participants and smokers, who despite being at higher risk of health problems, were less likely to report receiving preventive care. This suggests the need for greater effort to promote preventive care for these groups in Australian general practice.
    Full-text · Article · Jun 2013 · BMC Family Practice
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    • "Table 1 shows that the frequency of nutrition guidance practices was often higher than that of physical activity guidance practices. The studies of Kreuter et al. [19] and Booth and Nowson [20] were the only ones, which specifically asked for the combination of receiving advice for diet plus exercise against diet only and exercise only. "
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    ABSTRACT: OBJECTIVE: The aim of this critical review is to provide insight into the main outcomes of research on communication about nutrition and/or physical activity between GPs and patients for prevention or treatment of overweight and obesity. METHODS: Relevant studies were identified by a computerized search of multiple electronic databases (MEDLINE, PsycINFO) for all available papers between 1 January 1995 and 1 January 2012. In addition, two independent reviewers judged all studies on ten quality criteria. RESULTS: In total, 41 studies were retrieved. More studies were found about the guidance of obese patients than of overweight patients. The most common weight guidance practice was discussion of weight. The range of communication strategies for nutrition showed to be more diverse than for physical activity. Twelve studies were considered as high-quality studies, 18 were having medium quality, and 11 were seen as low quality. CONCLUSION: We reflected on the fact that the content of advice about nutrition and physical activity was quite general. GPs' provision of combined lifestyle advice to overweight and obese patients seems to be rather low. PRACTICE IMPLICATIONS: Observational research is needed to unravel the quality of the advice given by GPs to overweight and obese patients.
    Full-text · Article · Dec 2012 · Patient Education and Counseling
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