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BMC Primary Care
Published in: BMC Primary Care 1/2010

Open Access 01-12-2010 | Research article

Discussing patient's lifestyle choices in the consulting room: analysis of GP-patient consultations between 1975 and 2008

Authors: Janneke Noordman, Peter Verhaak, Sandra van Dulmen

Published in: BMC Primary Care | Issue 1/2010

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Abstract

Background

The increasing prevalence of chronic diseases and the growing understanding that lifestyle behaviour plays an essential role in improving overall health suggest a need for increased attention to lifestyle choices in the consulting room.
This study aims to examine whether or not healthy and unhealthy lifestyle choices of patients are currently being discussed more often in primary care consultations than in former decades. Furthermore, we are interested in GPs' approach to lifestyle behaviour during consultations. Lastly, we examine whether lifestyle behaviour is discussed more with certain patients during consultations, depending on gender, age and educational background.

Method

We analysed video-recordings of medical consultations, collected between 1975 and 2008 in Dutch GP practices. Data were analysed using logistic regression.

Results

This study shows that discussion of smoking behaviour and physical activity has increased somewhat over time. A change in discussion of nutrition and alcohol is, however, less clear. Overall, alcohol use is the least discussed and physical activity the most discussed during consultations. GPs mainly refer to lifestyle when it is relevant to the patient's complaints (symptom approach). GPs' approach to lifestyle behaviour did not change over time. In general, lifestyle behaviour is discussed more with older, male patients (except for nutrition). GPs talk about lifestyle behaviour with patients from different educational backgrounds equally (except for physical activity).

Conclusion

In recent years there is greater awareness of a healthy lifestyle, which is reflected to a limited extent in this study. Still, lifestyle behaviour is discussed in only a minority of consultations. GPs do not refer to lifestyle behaviour as a routine procedure, i.e. do not include it in primary prevention. This highlights the importance of the introduction of prevention consultations, where GPs can discuss lifestyle issues with patients who do not (yet) have risk symptoms.
Literature
1.
King DE, Mainous AG, Carnemolla M, Everett CJ: Adherence to healthy lifestyle habits in US adults, 1988-2006. The American Journal of Medicine. 2009, 122: 528-534. 10.1016/j.amjmed.2008.11.013.CrossRefPubMed
2.
WHO: Innovative care for chronic conditions: Building blocks for action. 2002, Genova: WHO
3.
Blank L, Grimsley M, Goyder E, Ellis E, Peters J: Community-based lifestyle interventions: changing behaviour and improving health. Journal of Public Health. 2007, 29: 236-245. 10.1093/pubmed/fdm041.CrossRefPubMed
4.
Li C, Ford ES, Mokdad AH, Jiles R, Giles WH: Clustering of multiple healthy lifestyle habits and health-related quality of life among US adults with diabetes. Diabetes Care. 2007, 30: 1770-1776. 10.2337/dc06-2571.CrossRefPubMed
5.
6.
Allin S, Mossialos E, McKee M, Holland W: Making decisions on public health. A review of eight countries. Copenhagen: European Observatory on Health Care Systems and Policies. 2004
7.
Van der Wilk EA, Melse JM, Broeder JM den, Achterberg PW: Leren van de buren. Beleid publieke gezondheid internationaal bezien: roken, alcohol, overgewicht, depressie, gezondheidsachterstanden, jeugd en screening. [Learning from the neighbours. Policy on public health international reviewed: smoking, alcohol, obesity, depression, health disadvantage, youth, and screening]. Bilthoven: RIVM. Houten: Bohn Stafleu Van Loghum. 2007
8.
Ministerie van Volksgezondheid VWS, Welzijn en Sport: Preventienota Kiezen voor gezond leven. [Prevention note Choosing healthy life]. Brief van de minister aan de Tweede Kamer. 2006, Den Haag
9.
Ministerie van Volksgezondheid VWS, Welzijn en Sport: Gezond zijn, gezond blijven. Een visie op gezondheid en preventie. Being healthy, staying healthy. A vision of health and prevention. 2007, Den Haag
10.
Milder IEJ, Blokstra A, Groot J de, Dulmen S van, Bemelmans WJE: Lifestyle counseling in hypertension-related visits - analysis of video-taped general practice visits. BMC Family Practice. 2008, 9: 58-10.1186/1471-2296-9-58.CrossRefPubMedPubMedCentral
11.
Glasgow RE, Eakin EG, Fisher EB, Bacak SJ, Brownson RC: Physician advice and support for physical activity. Results from a National Survey. American Journal of Preventive Medicine. 2001, 21 (3): 189-195. 10.1016/S0749-3797(01)00350-6.CrossRefPubMed
12.
Eakin EG, Glasgow RE, Riley KM: Review of primary care-based physical activity intervention studies. Journal of Family Practice. 2000, 49: 158-168.PubMed
13.
Laws RA, Jayasinghe UW, Harris MF, Williams AM, Powell Davies G, Kemp LA: Explaining the variation in the management of lifestyle risk factors in primary health care: A multilevel cross sectional study. BMC Public Health. 2009, 9 (165):
14.
Johansson K, Bendtsen P, Akerlind I: Advice to patients in Swedish primary care regarding alcohol and other lifestyle habits: how patients report the actions of GPs in relation to their own expectations and satisfaction with the consultation. European Journal of Public Health. 2005, 15: 615-620. 10.1093/eurpub/cki046.CrossRefPubMed
15.
Lawlor DA, Keen S, Neal RD: Increasing population levels of physical activity through primary care: GPs' knowledge, attitudes and self-reported practice. Family practice. 1999, 16: 250-254. 10.1093/fampra/16.3.250.CrossRefPubMed
16.
Lawlor DA, Keen S, Neal RD: Can general practitioners influence the nation's health through a population approach to provision of lifestyle advice?. British Journal of General Practice. 2000, 50: 455-459.PubMedPubMedCentral
17.
Nielen MMJ, Schellevis FG: Preventie in de huisartsenpraktijk anno 2008. De vroege opsporing van hart- en vaatziekten, diabetes mellitus en nierziekten [Prevention in general practice in 2008. Early detection of cardiovascular disease, diabetes mellitus and kidney disease]. 2008, Utrecht: NIVEL, Prevention in general practice in 2008. Early detection of cardiovascular disease, diabetes mellitus and kidney disease
18.
Hulshof KFAM, Brussaard JH, Kruizinga AG, Telman J, Löwik MRH: Socio-economic status, dietary intake and 10y trends: the Dutch National Food Consumption Survey. European Journal of Clinical Nutrition. 2003, 57: 128-137. 10.1038/sj.ejcn.1601503.CrossRefPubMed
19.
Coups EJ, Gaba A, Orleans CT: Physician screening for multiple behavioural health risk factors. Am J Prev Med. 2004, 27: 34-41. 10.1016/j.amepre.2004.04.021.CrossRefPubMed
20.
Mulder M, Ranchor AV, Sanderman S, Bouma J, Heuvel WJA van den: The stability of lifestyle behaviour. International Journal of Epidemiology. 1998, 27: 199-207. 10.1093/ije/27.2.199.CrossRefPubMed
21.
Qi V, Phillips SP, Hopman WM: Determinants of a healthy lifestyle and use of preventive screening in Canada. BMC public health. 2006, 7 (6): 275-10.1186/1471-2458-6-275.CrossRef
22.
Timpka T, Arborelius E: In what way may videotapes be used to get significant information about the patient-physician relationship?. Med. Theach. 1990, 12: 197-208. 10.3109/01421599009006697.CrossRef
23.
Bensing JM, Sluijs EM: Evaluation of an interview course for general practitioners. Social Science & Medicine. 1985, 20 (7): 737-744.CrossRef
24.
Verhaak PFM: Een evaluatie van de samenwerking tussen huisartsen en psycholoog in Capelle aan de IJssel. Nederlands Huisartsen Instituut (NIVEL). 1979, An evaluation of the cooperation between GPs and psychologist in Cappelle aan de IJssel
25.
Bensing JM, Verhaak PFM: Room for the patient. Doctor-patient communication and the quality of care: an observation study into affective and instrumental behavior in general practice. PhD thesis. 1991, Erasmus Universiteit Rotterdam. Utrecht: NIVEL
26.
Verhaak PFM: Detection of psychologic complaints by general practitioners. Medical Care. 1988, 26 (10): 1009-1020. 10.1097/00005650-198810000-00009.CrossRefPubMed
27.
Bensing JM, Foets M, Van der Velden J, Van der Zee J: De Nationale Studie van ziekten en verrichtingen in de huisartspraktijk: achtergronden en methoden. Huisarts en Wetenschap. 1991, 2: 51-61. The National Study of diseases and actions in general practice: background and method
28.
Brink-Muinen A van den, Verhaak PFM, Bensing JM, Bahrs O, Deveugele M, Gask L, Leiva F, Mead N, Messerli V, Oppizzi L, Peltenburg M, Perez A: Doctor-patient communication in different European health care systems: relevance and performance from the patients' perspective. Patient Education and Counseling. 2000, 1: 115-127. 10.1016/S0738-3991(99)00098-1.CrossRef
29.
Brink-Muinen van den A, Dulmen S van, de Haes HCJM, Visser APh, Schellevis FG, Bensing JM: Has patients' involvement in the decision-making process changed over time?. Health Expectations. 2006, 9: 333-342. 10.1111/j.1369-7625.2006.00413.x.CrossRefPubMed
30.
Noordman J, Verhaak PFM, Van Beljouw I, Van Dulmen S: Consulting room computers and their effect on general practitioner-patient communication: comparing two periods of computer use. Family Practice. 2010
31.
Sim J, Wright CC: The Kappa Statistic in Reliability Studies: Use, Interpretation, and Sample Size Requirements. Physical Therapy. 2005, 85 (3): 257-268.PubMed
32.
33.
WET van 9 oktober 2008, houdende bepalingen over de zorg voor de publieke gezondheid (Wet publieke gezondheid) [Law October 9th 2008, containing provisions on the care of public health (Public Health Act)]. Edited by: Beatrix, Klink A, Hirsch Ballin EMH. 2008, Den Haag, Law October 9th 2008, containing provisions on the care of public health (Public Health Act)
34.
Duaso MJ, Cheung P: Health promotion and lifestyle advice in general practice: what do patients think?. Journal of advanced nursing. 2002, 39 (5): 472-479. 10.1046/j.1365-2648.2002.02312.x.CrossRefPubMed
35.
Laurant MGH: Changes in skill mix: The impact of adding nurses to the primary care team. PhD thesis. 2007, Radbout Universiteit Nijmegen
36.
Richards A, Carley J, Jenkins-Clarke S, Richards DA: Skill mix between nurses and doctors working in primary care-delegation or allocation: a review of the literature. International Journal of Nursing Studies. 2000, 37: 185-197. 10.1016/S0020-7489(00)00005-5.CrossRefPubMed
37.
38.
Hingstman L, Kenens RJ: Cijfers uit de registratie van huisartsen: peiling 2009 [Figures from the registration of GPs: survey 2009]. 2009, Utrecht: NIVEL, Figures from the registration of GPs: survey 2009
39.
James PT, Leach R, Kalamara E, Shayeghi M: The worldwide obesity epidemic. Obesity Research. 2001, 9: s228-s233. 10.1038/oby.2001.123.CrossRef
40.
Metadata
Title
Discussing patient's lifestyle choices in the consulting room: analysis of GP-patient consultations between 1975 and 2008
Authors
Janneke Noordman
Peter Verhaak
Sandra van Dulmen
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2010
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-11-87

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