Training practitioners in primary care to deliver lifestyle advice

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f1763 (Published 19 March 2013)
Cite this as: BMJ 2013;346:f1763

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  1. Eileen Kaner, professor of public health research,
  2. Ruth McGovern, social worker and senior research interventionist
  1. 1Institute of Health and Society, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
  1. eileen.kaner{at}newcastle.ac.uk

More complex counselling may not lead to changes in patients’ health

Lifestyle choices and modifiable behaviours are responsible for a substantial number of premature deaths worldwide and years lived with disability or disease, as measured by disability adjusted life years (DALYs). The 2010 Global Burden of Disease study reported that the top three risks to health and wellbeing were high blood pressure (7% DALYs), smoking (6.3% DALYs), and alcohol use (5.5% DALYs). Dietary risk factors and physical inactivity jointly contributed a further 10% of DALYs.1 Hence the promotion of positive lifestyle change could improve patients’ health, and primary care is a key setting for this work. In a linked study (doi:10.1136/bmj.f1191), Butler and colleagues recognise that a necessary precursor to promoting behaviour change in patients is the need for practitioners to support such change.2 To make every clinical contact count,3 practitioners must recognise the underlying behavioural contribution to a presenting condition and apply a relevant intervention that supports positive behaviour change.

Changing behaviour is challenging and complex. Low intensity brief advice or counselling to reduce smoking and excessive alcohol consumption seems to have a positive …

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