Family Practice, Vol 14, 160-176, Copyright © 1997 by World Organization of Family Doctors
R Ashenden, C Silagy and D Weller
BACKGROUND: There is increasing evidence that particular lifestyle
behaviours increase the risk of disease and it is widely argued that GPs
are ideally placed to encourage patients to modify their behaviour in these
areas and thereby reduce their disease risk. There is therefore a need for
evidence that GP-based lifestyle interventions are effective in eliciting
behaviour change. As there has been no comprehensive attempt to review the
literature on this subject, we chose to conduct a systematic review,
incorporating meta-analytic techniques where possible, to address this
need. OBJECTIVES: This study aimed to examine how effective lifestyle
advice provided by GPs is in changing patient behaviour. The following four
areas of behaviour were examined: smoking, alcohol consumption, diet, and
exercise. METHOD: The review was restricted to English-language reports of
trials which investigated the effectiveness of lifestyle advice provided in
a general practice setting. Studies were included where it could be
established that subjects were randomly allocated to experimental groups
and where a comparison was made between either a "no intervention' or
"usual care' control group, or between advice of differing intensities. Six
electronic databases were searched and a total of 37 trials were selected
for inclusion in the review. Meta- analytic techniques were employed to
analyse the data from the smoking advice trials. The results form the
trials concerned with the other three behaviours did not lend themselves to
this form of analysis. Outcome data were extracted from these trials and
summarized in tabular form. RESULTS: The results of this review suggest
that whilst many of the general practice-based lifestyle interventions show
promise in effecting small changes in behaviour, none appears to produce
substantial changes. CONCLUSION: There is a need for more extensive and
rigorous research in this area before substantial public funds are
committed to general practice-based health promotion. Furthermore, it is
clear that if general practice-based interventions are to be effective in a
public health sense, a greater number of GPs will need to become involved
in promoting behaviour change than the literature suggests is currently
occurring.
REVIEWS
A systematic review of the effectiveness of promoting lifestyle change in general practice
Department of General Practice, School of Medicine, Flinders Medical Centre, Flinders University of South Australia, Australia.
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