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GP rejects study suggesting patients do not get lifestyle advice


Chelsea Heaney


7/05/2024 5:54:08 PM

According to new research, most Australians say they are not getting healthy lifestyle guidance from their GPs – but is that true?

GP with patient.
Data shows people are more likely to make a positive change if they recall receiving advice from their GP.

Australians are more likely to act on lifestyle changes when advised by their GP, but patients say they are not having those discussions, according to a new study.
 
The research, published in the Medical Journal of Australia, used the Australian Bureau of Statistics’ 2020–21 National Health Survey, in which participants were asked about health conditions, lifestyle risk factors and their use of healthcare.
 
According to the data analysed, just 27% of smokers were advised to quit, 8% of heavy drinkers were told to reduce their drinking, and 9% of people with unhealthy diets were instructed to eat more fruits and vegetables.
 
Of the 13,281 respondents, 20.1% said their alcohol intake was higher than the recommended maximum, 9.1% smoked, and 91.1% did not meet minimum dietary recommendations for fruit and vegetables.
 
They were asked if they received lifestyle advice from their GP during the last year in comparison to the one previous, including quitting smoking, lowering alcohol intake, reducing weight, increasing physical activity, and improving diet.
 
They were also asked if they had made any progress in those areas in the past year.
 
Researchers said the data showed people are more likely to have made a positive change if they recalled receiving advice from their GP.
 
‘Lifestyle advice from general practitioners may influence their patients’ health-related behaviour,’ they said.
 
For example, 8% of heavy drinkers reported being told by their doctor to cut down and 26% of those followed that advice.
 
In contrast, 19% of those who did not recall receiving a nudge from their GP to drop down on drinking reported doing so.
 
The study reports the proportion of people who recalled receiving GP-led lifestyle advice was ‘small’.
 
However, Associate Professor Magdalena Simonis – a member of RACGP Expert Committee – Quality Care (REC–QC) – told newsGP this is not an ‘accurate portrayal of the types of conversations’ GPs have with patients.
 
‘It’s a classic example of the data being interpreted outside of the context of the reason for the consultation and the long-term relationship a GP might have with a person,’ she said.
 
‘Person-centred care is about listening to the person who comes to you with their issue.
 
‘Taking the hardline on smoking, exercise, diet or alcohol when they have severe depression, schizophrenia or chronic pain risks detracting from the confidence they have in their GP and vulnerable patients fear being judged for their bad habits.’
 
Associate Professor Simonis said it is more important for GPs to provide the information a patient is seeking in a consult than to fit into an easily surveyable context.
 
‘If a woman comes in for her cervical screening test, we are unlikely to discuss issues around alcohol or smoking habits,’ she said.
 
‘If this was asked of those with chronic diseases such as diabetes, heart disease, cancer, weight loss and women planning for pregnancy, I expect the findings would be quite different.’
 
Meanwhile, REC–QC Chair Professor Mark Morgan told newsGP it was encouraging to see that people may be heeding doctors’ health guidance, but more in-depth research tools are needed to show the ‘extent and effectiveness of preventive activity in general practice’.
 
‘In an ideal world, GPs and their multidisciplinary teams would work in partnership with patients to optimise self-care,’ he said.
 
‘Our electronic medical records would have useful ways to record nuances of lifestyle factors.’
 
The RACGP partnered with the Department of Health and Aged Care last year to develop Healthy Habits, a platform that aims to support GPs and other healthcare providers with patients wanting to make positive lifestyle changes.
 
The free digital health program is designed to drive patient participation levels and improve and monitor outcomes in achieving a healthy lifestyle.
 
Dr Simonis said GPs often feel ‘like a broken record’ when encouraging change in their patients’ behaviour.
 
‘Most of these conversations are better placed after rapport and trust are established,’ she said.
 
‘It’s best achieved in partnership, despite what the stats in this paper suggest.
 
‘Lifestyle modification and behaviour change requires education and willingness on the part of the patient.’
 
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chronic disease management exercise GP-patient relationship health Healthy Habits lifestyle nutrition physical activity preventative health smoking


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Prof Moira Sim   12/05/2024 11:34:01 AM

Just to be clear, participants were not asked " if they received lifestyle advice from their GP during the last year in comparison to the one previous". The actual question the patients answered in the survey was "Have you discussed any of these issues with a GP in the last 12 months?". https://www.abs.gov.au/methodologies/national-health-survey-methodology/2020-21. This suggest the respondent has to think about whether they have raised this with a GP recently. It is not the same as asking if the GP has previously raised the issue either in the last 12 months or ever.