Our Healthier Nation: Are General Practitioners Willing and Able to Deliver? A Survey of Attitudes to and Involvement in Health Promotion and Lifestyle Counselling

Overview

Journal Br J Gen Pract

Specialty Public Health

Date 1999 May 27

PMID 10343420

Citations 42

Authors

B R McAvoy

E F Kaner

C A Lock

N Heather

E Gilvarry

Affiliations

Soon will be listed here.

Abstract

Background: The recent Green Paper, Our Healthier Nation, identifies professional advice on healthier living as a key component of its national contract for health. General practitioners (GPs) are ideally placed for this work. However, previous research has reported a discrepancy between patients' expectations of lifestyle advice from GPs and their receipt of such advice.

Aims: To describe GPs' current attitudes to and involvement in health promotion and lifestyle counselling, and to track changes in these areas over recent years.

Method: A postal questionnaire survey of a random sample of 430 GPs, one per practice, from all general practices in Leicestershire, Derbyshire, and Nottinghamshire. GPs who had not responded after two weeks received a reminder telephone call plus two follow-up questionnaires.

Results: Four hundred and eleven GPs were eligible for the survey, which yielded a response rate of 68% (n = 279). GPs reported spending an average 16% of practice time on prevention and 79% reported educating patients about lifestyle risk 'most' or 'all of the time'. Solo GPs spent more time on prevention than GPs from group practices. Most enquiries and interventions related to smoking behaviour. GPs felt most effective in changing patients' use of prescription drugs, and the largest reported difference between current and potential effectiveness in helping patient change lifestyle behaviour, after information and training, related to reducing alcohol consumption.

Conclusions: Despite an increasing workload, GPs remain positive about health promotion and lifestyle counselling. Over the past 10 years, there has been an increase in routine enquiries about lifestyle behaviour, but confidence about effectiveness in helping patients changes lifestyle behaviour remains low. More training and support concerning lifestyle intervention is required by GPs in order for them to contribute effectively to the Government's health promotion programme.

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References

Wechsler H, Levine S, Idelson R, ROHMAN M, Taylor J . The physician's role in health promotion--a survey of primary-care practitioners. N Engl J Med. 1983; 308(2):97-100. DOI: 10.1056/NEJM198301133080211. View

Wallace P, Haines A . General practitioner and health promotion: what patients think. Br Med J (Clin Res Ed). 1984; 289(6444):534-6. PMC: 1442700. DOI: 10.1136/bmj.289.6444.534. View

Anderson P . Managing alcohol problems in general practice. Br Med J (Clin Res Ed). 1985; 290(6485):1873-5. PMC: 1416789. DOI: 10.1136/bmj.290.6485.1873. View

Clement S . The identification of alcohol-related problems by general practitioners. Br J Addict. 1986; 81(2):257-64. DOI: 10.1111/j.1360-0443.1986.tb00325.x. View

Radecki S, Mendenhall R . Patient counselling by primary care physicians: results of a nationwide survey. Patient Educ Couns. 1986; 8(2):165-77. DOI: 10.1016/0738-3991(86)90087-x. View

Demak M, BECKER M . The doctor-patient relationship and counseling for preventive care. Patient Educ Couns. 1987; 9(1):5-24. DOI: 10.1016/0738-3991(87)90105-4. View

Wallace P, Brennan P, Haines A . Are general practitioners doing enough to promote healthy lifestyle? Findings of the Medical Research Council's general practice research framework study on lifestyle and health. Br Med J (Clin Res Ed). 1987; 294(6577):940-2. PMC: 1246006. DOI: 10.1136/bmj.294.6577.940. View

Coulter A, Schofield T . Prevention in general practice: the views of doctors in the Oxford region. Br J Gen Pract. 1991; 41(345):140-3. PMC: 1371511. View

Weller D, Litt J, Pols R, Ali R, Southgate D, Harris R . Drug and alcohol related health problems in primary care--what do GPs think?. Med J Aust. 1992; 156(1):43-8. View

10.

Bruce N, Burnett S . Prevention of lifestyle-related disease: general practitioners' views about their role, effectiveness and resources. Fam Pract. 1991; 8(4):373-7. DOI: 10.1093/fampra/8.4.373. View

11.

Hannay D, Usherwood T, PLATTS M . Workload of general practitioners before and after the new contract. BMJ. 1992; 304(6827):615-8. PMC: 1881361. DOI: 10.1136/bmj.304.6827.615. View

12.

Sutherland V, Cooper C . Job stress, satisfaction, and mental health among general practitioners before and after introduction of new contract. BMJ. 1992; 304(6841):1545-8. PMC: 1882446. DOI: 10.1136/bmj.304.6841.1545. View

13.

Silagy C, Muir J, Coulter A, Thorogood M, Yudkin P, Roe L . Lifestyle advice in general practice: rates recalled by patients. BMJ. 1992; 305(6858):871-4. PMC: 1883070. DOI: 10.1136/bmj.305.6858.871. View

14.

Calnan M, Williams S . Coronary heart disease prevention: the role of the general practitioner. Fam Pract. 1993; 10(2):137-51. DOI: 10.1093/fampra/10.2.137. View

15.

Murray T, Dyker G, Kelly M, Gilmour W, Campbell L . Demographic characteristics of general practitioners attending educational meetings. Br J Gen Pract. 1993; 43(376):467-9. PMC: 1372486. View

16.

Arborelius E, Bremberg S . Prevention in practice. How do general practitioners discuss life-style issues with their patients?. Patient Educ Couns. 1994; 23(1):23-31. DOI: 10.1016/s0738-3991(05)80018-7. View

17.

Lauritzen T, Leboeuf-Yde C, Lunde I, Nielsen K . Ebeltoft project: baseline data from a five-year randomized, controlled, prospective health promotion study in a Danish population. Br J Gen Pract. 1995; 45(399):542-7. PMC: 1239406. View

18.

Richmond R, Kehoe L, Heather N, Wodak A, Webster I . General practitioners' promotion of healthy life styles: what patients think. Aust N Z J Public Health. 1996; 20(2):195-200. DOI: 10.1111/j.1753-6405.1996.tb01818.x. View

19.

Adams P, Powell A, McCormick R . Incentives for general practitioners to provide brief interventions for alcohol problems. N Z Med J. 1997; 110(1049):291-4. View

20.

Deehan A, Taylor C, Strang J . The general practitioner, the drug misuser, and the alcohol misuser: major differences in general practitioner activity, therapeutic commitment, and 'shared care' proposals. Br J Gen Pract. 1998; 47(424):705-9. PMC: 1409931. View