Silagy C, Muir J, Coulter A, Thorogood M, Yudkin P, Roe L
University Department of Public Health and Primary Care, Radcliffe Infirmary, Oxford.
BMJ. 1992 Oct 10;305(6858):871-4. doi: 10.1136/bmj.305.6858.871.
To document how often patients with varying cardiovascular risk levels reported receiving lifestyle advice from general practice.
Cross sectional descriptive survey by postal questionnaire.
5 general practices in Bedfordshire.
4941 people aged 35-64 years who had consulted a general practitioner at least once during the 12 months before completing the questionnaire and who subsequently attended for a health check as part of the OXCHECK trial.
Report of having received advice from a general practitioner or practice nurse about smoking, alcohol consumption, exercise, or diet during the 12 months before completing the questionnaire. Cardiovascular risk assessed by a nurse during structured health check.
The overall reported rate of advice was 27% for smoking, 4.5% for exercise, 12% for diet, and 3% for alcohol consumption. Those with unhealthy behaviour profile or at increased cardiovascular risk received more advice--for example, 47% of smokers with a history of cardiovascular disease received advice on smoking. Among those at increased risk, men were more likely than women to receive advice about exercise (11% v 4%, p = 0.04) and alcohol consumption (10% v 4%, p = 0.007), while women received more advice about weight (17% v 23%, p < 0.001). The rate of receiving advice was unaffected by age, marital status, or social class.
The low rate of lifestyle advice reported by patients implies that more preventive advice could be provided in primary care.
记录不同心血管风险水平的患者报告从全科医疗中获得生活方式建议的频率。
通过邮寄问卷进行横断面描述性调查。
贝德福德郡的5家全科医疗机构。
4941名年龄在35 - 64岁之间的人，他们在完成问卷前的12个月内至少咨询过一次全科医生，随后作为OXCHECK试验的一部分参加了健康检查。
在完成问卷前的12个月内，报告从全科医生或执业护士处获得关于吸烟、饮酒、运动或饮食建议的情况。由护士在结构化健康检查中评估心血管风险。
报告的建议总体接受率为：吸烟27%，运动4.5%，饮食12%，饮酒3%。有不健康行为特征或心血管风险增加的人接受的建议更多——例如，有心血管疾病史的吸烟者中有47%接受了关于吸烟的建议。在风险增加的人群中，男性比女性更有可能接受关于运动的建议（11%对4%，p = 0.04）和饮酒的建议（10%对4%，p = 0.007），而女性接受关于体重的建议更多（17%对23%，p < 0.001）。接受建议的比例不受年龄、婚姻状况或社会阶层的影响。
患者报告的生活方式建议接受率较低，这意味着在初级保健中可以提供更多的预防性建议。
