Counseling overweight patients: analysis of preventive encounters in primary care

Sonntag, Ulrike; Henkel, Jeffrey; Renneberg, Babette; Bockelbrink, Angelina; Braun, Vittoria; Heintze, Christoph

doi:10.1093/intqhc/mzq060

Cited by 19 publications

(28 citation statements)

References 31 publications

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“…For example, GPs rarely engage in lifestyle counseling with obese patients during their regular consultations [17]. Further, while many GPs report using verbal counseling for risk factors such as lack of physical activity, they rarely provide referrals or written action plans [18].…”

Section: Importance Of Preventive Care In Optimizing Health Outcomesmentioning

confidence: 99%

The Role of eHealth in Optimizing Preventive Care in the Primary Care Setting

Carey

Noble²,

Mansfield³

et al. 2015

J Med Internet Res

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Modifiable health risk behaviors such as smoking, overweight and obesity, risky alcohol consumption, physical inactivity, and poor nutrition contribute to a substantial proportion of the world’s morbidity and mortality burden. General practitioners (GPs) play a key role in identifying and managing modifiable health risk behaviors. However, these are often underdetected and undermanaged in the primary care setting. We describe the potential of eHealth to help patients and GPs to overcome some of the barriers to managing health risk behaviors. In particular, we discuss (1) the role of eHealth in facilitating routine collection of patient-reported data on lifestyle risk factors, and (2) the role of eHealth in improving clinical management of identified risk factors through provision of tailored feedback, point-of-care reminders, tailored educational materials, and referral to online self-management programs. Strategies to harness the capacity of the eHealth medium, including the use of dynamic features and tailoring to help end users engage with, understand, and apply information need to be considered and maximized. Finally, the potential challenges in implementing eHealth solutions in the primary care setting are discussed. In conclusion, there is significant potential for innovative eHealth solutions to make a contribution to improving preventive care in the primary care setting. However, attention to issues such as data security and designing eHealth interfaces that maximize engagement from end users will be important to moving this field forward.

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Section: Importance Of Preventive Care In Optimizing Health Outcomesmentioning

confidence: 99%

The Role of eHealth in Optimizing Preventive Care in the Primary Care Setting

Carey

Noble²,

Mansfield³

et al. 2015

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…Patients with a higher BMI receive more physician advice for weight loss and spend more time with the physician than patients who have less severe levels of overweight and obesity. [2,3,12,13] Patients with less education, younger age, and those who have not yet developed weight-related comorbidities are less likely to receive physician counseling. [2] Also, women are more likely than men to receive physician recommendations for weight loss, [7,14] and there is some evidence that physicians recommend greater amounts of weight loss for women than men of comparable weight status.…”

Section: Introductionmentioning

confidence: 99%

“…[18] In one study, female physicians spent more time discussing nutritional information, whereas male physicians were more inclined to discuss cardiovascular risk. [13] However, another study indicated that male patients seeing a male physician received more nutritional and exercise counseling than female patients seeing a female physician. [20] Furthermore, significant differences in the weight loss goals provided by male and female physicians have been documented, with male physicians recommending weight goals to patients that would require significantly greater losses.…”

Section: Introductionmentioning

confidence: 99%

Patient and physician characteristics associated with the provision of weight loss counseling in primary care

Dutton

Herman

Tan

et al. 2014

Obesity Research & Clinical Practice

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Background A variety of physician and patient characteristics may influence whether weight loss counseling occurs in primary care encounters. Objectives This study utilized a cross-sectional survey of primary care patients, which examined patient characteristics, physician characteristics, and characteristics of the physician-patient relationship associated with weight loss counseling and recommendations provided by physicians. Participants Participants (N=143, mean age=46.8 years, mean BMI=36.9 kg/m2, 65% Caucasian) were overweight and obese primary care patients participating in a managed care weight loss program. Measures Participants completed self-report surveys in the clinic prior to the initial weight loss session. Surveys included items assessing demographic/background characteristics, weight, height, and a health care questionnaire evaluating whether their physician had recommended weight loss, the frequency of their physicians’ weight loss counseling, and whether their physician had referred them for obesity treatment. Results Patient BMI and physician sex were most consistently associated with physicians’ weight loss counseling practices. Patients seen by female physicians were more likely to be told that they should lose weight, received more frequent obesity counseling, and were more likely to have been referred for obesity treatment by their physician. Length and frequency of physician-patient contacts were unrelated to the likelihood of counseling. Conclusions These findings add to previous evidence suggesting possible differences in the weight loss counseling practices of male and female physicians, although further research is needed to understand this potential difference between physicians.

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“…This gap between beliefs and practice raises questions regarding the role of primary prevention in GPs’ offices. Thus far, only a few studies have looked at the practice of primary prevention in GPs’ offices [25-28]. The purpose of this study was to understand current primary prevention practices in general care and the attitudes and beliefs that GPs in Germany hold about primary prevention.…”

Section: Introductionmentioning

confidence: 99%

Primary prevention in general practice – views of German general practitioners: a mixed-methods study

et al. 2014

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BackgroundPolicy efforts focus on a reorientation of health care systems towards primary prevention. To guide such efforts, we analyzed the role of primary prevention in general practice and general practitioners’ (GPs) attitudes toward primary prevention.MethodsMixed-method study including a cross-sectional survey of all community-based GPs and focus groups in a sample of GPs who collaborated with the Institute of General Practice in Berlin, Germany in 2011. Of 1168 GPs 474 returned the mail survey. Fifteen GPs participated in focus group discussions. Survey and interview guidelines were developed and tested to assess and discuss beliefs, attitudes, and practices regarding primary prevention.ResultsMost respondents considered primary prevention within their realm of responsibility (70%). Primary prevention, especially physical activity, healthy eating, and smoking cessation, was part of the GPs’ health care recommendations if they thought it was indicated. Still a quarter of survey respondents discussed reduction of alcohol consumption with their patients infrequently even when they thought it was indicated. Similarly 18% claimed that they discuss smoking cessation only sometimes. The focus groups revealed that GPs were concerned about the detrimental effects an uninvited health behavior suggestion could have on patients and were hesitant to take on the role of “health policing”. GPs saw primary prevention as the responsibility of multiple actors in a network of societal and municipal institutions.ConclusionsThe mixed-method study showed that primary prevention approaches such as lifestyle counseling is not well established in primary care. GPs used a selective approach to offer preventive advice based upon indication. GPs had a strong sense that a universal prevention approach carried the potential to destroy a good patient-physician relationship. Other approaches to public health may be warranted such as a multisectoral approach to population health. This type of restructuring of the health care sector may benefit patients who are unable to afford specific prevention programmes and who have competing demands that hinder their ability to focus on behavior change.

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Counseling overweight patients: analysis of preventive encounters in primary care

Abstract: Our results indicate that GPs rarely use the check-up program to conduct lifestyle consultations with obese patients. Barriers to lifestyle counseling and possible solutions are discussed with a view to promoting individualized and target management of overweight patients.

Cited by 19 publications

References 31 publications

The Role of eHealth in Optimizing Preventive Care in the Primary Care Setting

The Role of eHealth in Optimizing Preventive Care in the Primary Care Setting

Patient and physician characteristics associated with the provision of weight loss counseling in primary care

Primary prevention in general practice – views of German general practitioners: a mixed-methods study

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