GPs' assessment of patients' readiness to change diet, activity and smoking

M.W. Verheijden, J.C. Bakx, I.C.G. Delemarre, A.J. Wanders, N.M. van Woudenbergh, B.J. Bottema, C. van Weel, W.A. van Staveren

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Abstract

The Stages of Change Model is increasingly used for lifestyle counselling. In general practice, the use of algorithms to measure stage of change is limited, but for successful counselling it is important to know patients' readiness to change. Aim: To assess the accuracy of the assessment of patients' readiness to change fat consumption, physical activity, and smoking by GPs and general practice registrars. Design of Study: Cross-sectional questionnaire-based survey. Setting: One hundred and ninety-nine patients at elevated cardiovascular risk aged 40-70 years, 24 GPs, and 21 registrars in Dutch general practices. Method: Patients were asked to complete an algorithm to measure their motivation to change fat consumption, physical activity, and smoking. GPs and registrars were given descriptions of the stages of change for the three lifestyles, and were asked to indicate the description that matched their patient. Cohen's ¿ was calculated as measure of agreement between patients and GPs/registrars. Results: Registrars' patients were younger, and less often overweight and hypertensive than GPs' patients. Cohen's ¿ for smoking was moderate (0.50, 95% confidence interval [CI] = 0.34 to 0.67 for GPs and 0.47, CI = 0.27 to 0.68 for registrars). Agreement for fat and activity was poor to fair. No differences in accuracy were observed between GPs and registrars (P = 0.07-0.83). Conclusions: Low accuracy indicates that counselling in general practice is often targeted at the wrong people at the wrong time. Improvements can possibly be achieved by making registration of lifestyle parameters in patient records common practice, and by simply asking patients where they stand in respect to lifestyle change
Original languageEnglish
Pages (from-to)452-457
JournalBritish Journal of General Practice
Volume55
Issue number515
Publication statusPublished - 2005

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Smoking
Diet
General Practice
Life Style
Counseling
Fats
Confidence Intervals
Exercise
Motivation
Cross-Sectional Studies

Keywords

  • coronary-heart-disease
  • physical-activity
  • transtheoretical model
  • integrative model
  • general-practice
  • behavior-change
  • increased risk
  • primary-care
  • fat intake
  • stage

Cite this

Verheijden, M. W., Bakx, J. C., Delemarre, I. C. G., Wanders, A. J., van Woudenbergh, N. M., Bottema, B. J., ... van Staveren, W. A. (2005). GPs' assessment of patients' readiness to change diet, activity and smoking. British Journal of General Practice, 55(515), 452-457.
Verheijden, M.W. ; Bakx, J.C. ; Delemarre, I.C.G. ; Wanders, A.J. ; van Woudenbergh, N.M. ; Bottema, B.J. ; van Weel, C. ; van Staveren, W.A. / GPs' assessment of patients' readiness to change diet, activity and smoking. In: British Journal of General Practice. 2005 ; Vol. 55, No. 515. pp. 452-457.
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title = "GPs' assessment of patients' readiness to change diet, activity and smoking",
abstract = "The Stages of Change Model is increasingly used for lifestyle counselling. In general practice, the use of algorithms to measure stage of change is limited, but for successful counselling it is important to know patients' readiness to change. Aim: To assess the accuracy of the assessment of patients' readiness to change fat consumption, physical activity, and smoking by GPs and general practice registrars. Design of Study: Cross-sectional questionnaire-based survey. Setting: One hundred and ninety-nine patients at elevated cardiovascular risk aged 40-70 years, 24 GPs, and 21 registrars in Dutch general practices. Method: Patients were asked to complete an algorithm to measure their motivation to change fat consumption, physical activity, and smoking. GPs and registrars were given descriptions of the stages of change for the three lifestyles, and were asked to indicate the description that matched their patient. Cohen's ¿ was calculated as measure of agreement between patients and GPs/registrars. Results: Registrars' patients were younger, and less often overweight and hypertensive than GPs' patients. Cohen's ¿ for smoking was moderate (0.50, 95{\%} confidence interval [CI] = 0.34 to 0.67 for GPs and 0.47, CI = 0.27 to 0.68 for registrars). Agreement for fat and activity was poor to fair. No differences in accuracy were observed between GPs and registrars (P = 0.07-0.83). Conclusions: Low accuracy indicates that counselling in general practice is often targeted at the wrong people at the wrong time. Improvements can possibly be achieved by making registration of lifestyle parameters in patient records common practice, and by simply asking patients where they stand in respect to lifestyle change",
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author = "M.W. Verheijden and J.C. Bakx and I.C.G. Delemarre and A.J. Wanders and {van Woudenbergh}, N.M. and B.J. Bottema and {van Weel}, C. and {van Staveren}, W.A.",
year = "2005",
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volume = "55",
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Verheijden, MW, Bakx, JC, Delemarre, ICG, Wanders, AJ, van Woudenbergh, NM, Bottema, BJ, van Weel, C & van Staveren, WA 2005, 'GPs' assessment of patients' readiness to change diet, activity and smoking', British Journal of General Practice, vol. 55, no. 515, pp. 452-457.

GPs' assessment of patients' readiness to change diet, activity and smoking. / Verheijden, M.W.; Bakx, J.C.; Delemarre, I.C.G.; Wanders, A.J.; van Woudenbergh, N.M.; Bottema, B.J.; van Weel, C.; van Staveren, W.A.

In: British Journal of General Practice, Vol. 55, No. 515, 2005, p. 452-457.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - GPs' assessment of patients' readiness to change diet, activity and smoking

AU - Verheijden, M.W.

AU - Bakx, J.C.

AU - Delemarre, I.C.G.

AU - Wanders, A.J.

AU - van Woudenbergh, N.M.

AU - Bottema, B.J.

AU - van Weel, C.

AU - van Staveren, W.A.

PY - 2005

Y1 - 2005

N2 - The Stages of Change Model is increasingly used for lifestyle counselling. In general practice, the use of algorithms to measure stage of change is limited, but for successful counselling it is important to know patients' readiness to change. Aim: To assess the accuracy of the assessment of patients' readiness to change fat consumption, physical activity, and smoking by GPs and general practice registrars. Design of Study: Cross-sectional questionnaire-based survey. Setting: One hundred and ninety-nine patients at elevated cardiovascular risk aged 40-70 years, 24 GPs, and 21 registrars in Dutch general practices. Method: Patients were asked to complete an algorithm to measure their motivation to change fat consumption, physical activity, and smoking. GPs and registrars were given descriptions of the stages of change for the three lifestyles, and were asked to indicate the description that matched their patient. Cohen's ¿ was calculated as measure of agreement between patients and GPs/registrars. Results: Registrars' patients were younger, and less often overweight and hypertensive than GPs' patients. Cohen's ¿ for smoking was moderate (0.50, 95% confidence interval [CI] = 0.34 to 0.67 for GPs and 0.47, CI = 0.27 to 0.68 for registrars). Agreement for fat and activity was poor to fair. No differences in accuracy were observed between GPs and registrars (P = 0.07-0.83). Conclusions: Low accuracy indicates that counselling in general practice is often targeted at the wrong people at the wrong time. Improvements can possibly be achieved by making registration of lifestyle parameters in patient records common practice, and by simply asking patients where they stand in respect to lifestyle change

AB - The Stages of Change Model is increasingly used for lifestyle counselling. In general practice, the use of algorithms to measure stage of change is limited, but for successful counselling it is important to know patients' readiness to change. Aim: To assess the accuracy of the assessment of patients' readiness to change fat consumption, physical activity, and smoking by GPs and general practice registrars. Design of Study: Cross-sectional questionnaire-based survey. Setting: One hundred and ninety-nine patients at elevated cardiovascular risk aged 40-70 years, 24 GPs, and 21 registrars in Dutch general practices. Method: Patients were asked to complete an algorithm to measure their motivation to change fat consumption, physical activity, and smoking. GPs and registrars were given descriptions of the stages of change for the three lifestyles, and were asked to indicate the description that matched their patient. Cohen's ¿ was calculated as measure of agreement between patients and GPs/registrars. Results: Registrars' patients were younger, and less often overweight and hypertensive than GPs' patients. Cohen's ¿ for smoking was moderate (0.50, 95% confidence interval [CI] = 0.34 to 0.67 for GPs and 0.47, CI = 0.27 to 0.68 for registrars). Agreement for fat and activity was poor to fair. No differences in accuracy were observed between GPs and registrars (P = 0.07-0.83). Conclusions: Low accuracy indicates that counselling in general practice is often targeted at the wrong people at the wrong time. Improvements can possibly be achieved by making registration of lifestyle parameters in patient records common practice, and by simply asking patients where they stand in respect to lifestyle change

KW - coronary-heart-disease

KW - physical-activity

KW - transtheoretical model

KW - integrative model

KW - general-practice

KW - behavior-change

KW - increased risk

KW - primary-care

KW - fat intake

KW - stage

M3 - Article

VL - 55

SP - 452

EP - 457

JO - British Journal of General Practice

JF - British Journal of General Practice

SN - 0960-1643

IS - 515

ER -

Verheijden MW, Bakx JC, Delemarre ICG, Wanders AJ, van Woudenbergh NM, Bottema BJ et al. GPs' assessment of patients' readiness to change diet, activity and smoking. British Journal of General Practice. 2005;55(515):452-457.