What predicts patient-reported GP management of smoking, nutrition, alcohol, physical activity and weight?

2012 ◽  
Vol 18 (2) ◽  
pp. 123 ◽  
Author(s):  
Mark F. Harris ◽  
Mahnaz Fanaian ◽  
Upali W. Jayasinghe ◽  
Megan Passey ◽  
David Lyle ◽  
...  

This study aimed to describe patient-reported management of behavioural risk factors in Australian general practice. Six hundred and ninety-eight eligible patients from 30 general practices in two rural and three urban Divisions of General Practice responded to a mailed invitation to participate and completed a questionnaire. Data were analysed using univariate and multi-level multivariate methods. The prevalence of risk factors varied between 12.6% for smoking and 72.6% for at-risk diet (56.2% were overweight). Most patients were at the action or maintenance phases of their readiness to change their risky behaviours. General practitioners (GPs) provided education or advice to between one-quarter and one-third of those at risk for each risk factor; 9.2% and 9.6% of patients reported having been referred for diet or physical activity interventions. Patient body mass index was associated with increased likelihood of receiving GP advice or referral for diet and physical activity interventions. Having poor diet or physical activity levels and being more ready for change were not associated with the likelihood of GP referral. The major challenge for general practice is to ensure that effective lifestyle interventions are provided to those who will most benefit. Patient-reported GP behavioural risk factor advice and referral is less frequent than is optimal. Priority needs to be given to those most at risk and ready to change their behaviour.

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Lynda H. Norton ◽  
Kevin I. Norton ◽  
Nicole R. Lewis

Background.Low physical activity (PA) levels are associated with poor health risk factor profiles. Intervention strategies to increase PA and quantify the rate and magnitude of change in risk factors are important.Methods.Interventions were conducted over 40 days to increase PA in 736 insufficiently active (<150 min/wk PA) participants using either a pedometer or instructor-led group protocol. There were a further 135 active participants as controls. Major cardiovascular and metabolic risk factors, including fitness parameters, were measured before and after intervention.Results.Adherence to the interventions was higher for the group versus pedometer participants (87.1% versus 79.8%) and compliance rates for achieving sufficient levels of PA (≥150 min/wk) were also higher for the group participants (95.8% versus 77.6%). Total weekly PA patterns increased by 300 and 435 minutes, for the pedometer and group participants, respectively. Improvements were found for waist girth, total cholesterol, aerobic fitness, and flexibility relative to controls. The change in vigorous PA, but not moderate PA, was a significant predictor of the change in eight of 11 risk factor variables measured.Conclusions.Rapid and dramatic increases in PA among previously insufficiently active adults can result in important health benefits.


1994 ◽  
Vol 11 (3) ◽  
pp. 132-144 ◽  
Author(s):  
Peita Graham-Clarke ◽  
Brian Oldenburg

Physical inactivity is a risk factor for a number of chronic diseases, including cardiovascular disease. Interventions designed to reduce the prevalence of physical inactivity have focused primarily on either adoption of physical activity or noncompliance and relapse, and no interventions have been reported which cover adoption, compliance, maintenance, and relapse, particularly within the clinical setting. TheFresh Startprogram, a multiple risk factor intervention program for the reduction of cardiovascular disease risk factors in general practice patients, was developed to cover all aspects of the adoption and maintenance of habitual physical activity, using Prochaska and DiClemente's Transtheoretical model. The evaluation of the program on cardiovascular disease risk factors and behaviours provided the opportunity to evaluate the impact of a staged program on patient physical activity behaviour. The program was evaluated in a randomised controlled trial in Sydney's Western, South-western, and Wentworth regions with 80 volunteer general practitioners and 758 volunteer patients between January 1991 and January 1993. Self-reported physical activity data were used as the basis for estimating energy expenditure due to leisure-time physical activity. The results failed to show any differences between groups over time, as a function of patients' baseline stages of change, and as a function of baseline activity levels. There were some indications, however, that the least active would respond to doctor-based advice to increase their physical activity, and that doctor advice would lead to a progression inintention to changein approximately 20% of patients. Limitations of the study, the program, and physical activity intervention in the clinical setting are discussed.


2005 ◽  
Vol 11 (2) ◽  
pp. 120 ◽  
Author(s):  
Cheryl Amoroso ◽  
Coletta Hobbs ◽  
Mark F Harris

The objective of this study is to examine current activities, barriers, and capacity needs for the assessment and management of smoking, nutrition, alcohol and physical activity behavioural risk factors in rural and urban general practices. A cross-sectional survey of 287 general practitioners (GPs) was conducted in a rural and urban Division of General Practice in NSW. A total of 146 GPs responded yielding Divisional response rates of 51% rural and 61% urban. For each of the SNAP risk factors, between 37% and 46% of GPs report using guidelines. Verbal advice is given "very often" for smoking by 68% of GPs, for nutrition and alcohol by 48%, and physical activity by 60%. Guideline use is associated with increased frequency of advising patients. Patient compliance is the most frequently reported barrier to giving advice, especially for smoking and alcohol. GPs report that they "often" or "very often" refer patients due to nutritional risk factors (48%), with lower referral rates reported for physical activity and alcohol risk factors (28% and 27% respectively). Only 10% refer patients "often" or "very often" for smoking management, and referral for smoking management and physical activity increase as a result of training in these areas. There is considerable variability in smoking, nutrition, alcohol and physical activity risk factor intervention and management in the general practice setting. A range of strategies is required to improve the systematic management of risk factors including training, use of guidelines, referral networks, and patient education.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. Flook ◽  
C. Jackson ◽  
E. Vasileiou ◽  
C. R. Simpson ◽  
M. D. Muckian ◽  
...  

Abstract Background Severe Acute Respiratory Syndrome coronavirus-2 (SARS-CoV-2) has challenged public health agencies globally. In order to effectively target government responses, it is critical to identify the individuals most at risk of coronavirus disease-19 (COVID-19), developing severe clinical signs, and mortality. We undertook a systematic review of the literature to present the current status of scientific knowledge in these areas and describe the need for unified global approaches, moving forwards, as well as lessons learnt for future pandemics. Methods Medline, Embase and Global Health were searched to the end of April 2020, as well as the Web of Science. Search terms were specific to the SARS-CoV-2 virus and COVID-19. Comparative studies of risk factors from any setting, population group and in any language were included. Titles, abstracts and full texts were screened by two reviewers and extracted in duplicate into a standardised form. Data were extracted on risk factors for COVID-19 disease, severe disease, or death and were narratively and descriptively synthesised. Results One thousand two hundred and thirty-eight papers were identified post-deduplication. Thirty-three met our inclusion criteria, of which 26 were from China. Six assessed the risk of contracting the disease, 20 the risk of having severe disease and ten the risk of dying. Age, gender and co-morbidities were commonly assessed as risk factors. The weight of evidence showed increasing age to be associated with severe disease and mortality, and general comorbidities with mortality. Only seven studies presented multivariable analyses and power was generally limited. A wide range of definitions were used for disease severity. Conclusions The volume of literature generated in the short time since the appearance of SARS-CoV-2 has been considerable. Many studies have sought to document the risk factors for COVID-19 disease, disease severity and mortality; age was the only risk factor based on robust studies and with a consistent body of evidence. Mechanistic studies are required to understand why age is such an important risk factor. At the start of pandemics, large, standardised, studies that use multivariable analyses are urgently needed so that the populations most at risk can be rapidly protected. Registration This review was registered on PROSPERO as CRD42020177714.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R Martinez-Rueda ◽  
M A Camacho ◽  
I J Díaz

Abstract Background The changes generated in the studentś lifestyle due to the academic demands, may favour the prevalence of risk factors for non-communicable diseases as well as compromise other domains of their life. The purpose of this study was to establish the prevalence of behavioural risk factors in students of the Professional in Physical Activity and Sports program of a University in Bucaramanga, Colombia. Methods A cross-sectional study with a sample of 189 students was conducted. The students were surveyed with the first step of the STEPs questionnaire, which evaluates the behavioural risk factors for non-communicable diseases. A descriptive data analysis was performed, and Pearson tests were applied to determine the correlation between the analysed variables with a level of significance α = 0.05 using STATA 13.0. Results 80% of the participants were men. The age average was 22.7 ± 3.85 years. Regarding tobacco use, 10.1% of the participants were current smokers, while 30% smoked before. The majority of the participants (92.2%) have consumed alcohol within the past 12 months, while 69.8% consumed alcohol within the last month, with 8.7% of hazardous drinking. Concerning the diet, only 24.9% met the recommended consumption of fruits and vegetables per day. When assessing physical activity levels, only 6.3% were classified as physically inactive. Additionally, an average of 6 hours of sedentary behaviour was found, with 31.2% of excessive sedentary time. A weak correlation was found between age and academic cycle with the amount of physical activity at work (r = 0.24), (r = 0.18) and with sedentary time (r = -0.28), (-0, 32). Conclusions Although the prevalence of tobacco consumption was slightly higher than the national average, the students showed a lower prevalence of behavioural risk factors than the general population. However, it is necessary to promote strategies aimed at the control and prevention of these risk factors. Key messages Being a student of a program focused on physical activity and sport, can behave as a protective factor against the most prevalent risk factors in university life. It is necessary to implement more strategies centred on making students aware of the importance of the maintenance and improvement of their lifestyles in accordance with their professional profile.


2011 ◽  
Vol 17 (3) ◽  
pp. 233 ◽  
Author(s):  
Anthea Worley ◽  
Karen Grimmer-Somers

Glaucoma is an insidious eye disease, potentially putting 4% of older Australians at risk of blindness, unless detected sufficiently early for initiation of effective treatment. This paper reports on the strengths of evidence and glaucoma risk factors that can be identified by primary health care providers from a patient’s history. A comprehensive search of peer-reviewed databases identified relevant secondary evidence published between 2002 and 2007. Risk factors that could be determined from a patient’s history were identified. A novel glaucoma risk factor reference guide was constructed according to evidence strength and level of concern regarding risk of developing glaucoma. The evidence is strong and consistent regarding the risk of developing glaucoma, and elevated intraocular pressure, advancing age, non-Caucasian ethnicity and family history of glaucoma. There is moderate evidence of association with glaucoma, and migraine, eye injury, myopia and long-term use of corticosteroids. There is conflicting evidence for living in a rural location, high blood pressure, diabetes and smoking. Early detection of people at risk of developing glaucoma can be initiated using our risk factor guide coupled with a comprehensive patient history. Timely future assessment and subsequent management strategies for at-risk individuals can then be effectively and efficiently actioned.


2018 ◽  
Vol 21 (1A) ◽  
Author(s):  
Zdzisława Chmiel ◽  
Grażyna Hejda ◽  
Monika Binkowska-Bury

Introduction. A World Health Organization (WHO) conference on a “second wave” epidemic of cardiovascular diseases, directly linked to arterial sclerosis (AS), predicts that in 2020 cardiovascular diseases will most likely be the leading cause of death in the world. The development of AS begins in youth and progresses with age. It’s intensity depends on the risk factors involved, such as: smoking, hypertension, obesity and fat and sugar disorders in the body. Aim. The aim of this study was to establish the risk factors of cardiovascular diseases and their existence, among the youth of the upper gymnasium school. Material and methods. The research was conducted using 511 volunteer students from upper and lower gymnasium schools, between 16-19 years of age. Our research methods included: a diagnostic questionnaire, the measurement of blood pressure (BP) and anthropometric measurements. In the statistical study, we used chi-square independence testing, the V-Kramer test and the tau-b Kendall test; the level of changes α = 0.05 – was used. Results. Over a half of the study group (52.5%) was characterised with the lack of recommended physical activity, much more common in girls than boys (p = 0.000), just like smoking (p = 0.009) which was declared by 39.7% of the interviewed youth. In turn, a heightened value of systolic and diastolic pressure occurred more often in boys (19.6%) than in girls (12.1%); (p = 0.000 vs. p = 0.003). Excessive body mass was noted in 15.7% of the respondents, also more often in boys than in girls (p = 0.02), and abdominal obesity occurred in 10.2% of the respondents, with no significant differences between the sexes. 42.3% of the respondents showed one, 29.9% showed two and 18.8% showed three atherosclerosis risk factors. 9.0% of the study group showed 4 and more such risk factors. Accumulation of atherosclerosis risk factors occurred significantly more often in girls than in boys (p = 0.002). Conclusions. In all the respondents at least one atherosclerosis risk factor was found, and in over half of the study group, more frequently in girls than in boys, an accumulation of two or more risk factors was observed. Lack of recommended physical activity was the most frequent atherosclerosis risk factor occurring in the youth.


2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Ashish Atreja ◽  
Ashish Aggarwal ◽  
Angelo A. Licata ◽  
Bret A. Lashner

Background. Patients with inflammatory bowel disease (IBD) are at high risk of developing osteoporosis. Our objective was to determine the usefulness of IBD guidelines in identifying patients at risk for developing osteoporosis.Methods. We utilized institutional repository to identify patients seen in IBD center and extracted data on demographics, disease history, conventional, and nonconventional risk factors for osteoporosis and Dual Energy X-ray Absorptiometry (DXA) findings.Results. 59% of patients (1004/1703) in our IBD cohort had at least one risk factor for osteoporosis screening. DXA was documented in 263 patients with indication of screening (provider adherence, 26.2%), and of these, 196 patients had DXA completed (“at-risk” group). Ninety-five patients not meeting guidelines-based risk factors also had DXA completed (“not at-risk” group). 139 (70.9%) patients in “at-risk” group had low BMD, while 51 (53.7%) of “not-at-risk” patients had low BMD. Majority of the patients with osteoporosis (83.3%) missed by the current guidelines had low BMI. Multivariate logistic regression analysis showed that low BMI was the strongest risk factor for osteoporosis (OR 3.07; 95% CI, 1.47–6.42;P=0.003).Conclusions. Provider adherence to current guidelines is suboptimal. Low BMI can identify majority of the patients with osteoporosis that are missed by current guidelines.


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