Abstract P077: Missed Opportunities for Behavioral Counseling by Primary Care Providers

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Abstract

Background: In 2014, the US Preventive Services Task Force recommended adults who are overweight or obese and have additional cardiovascular disease (CVD) risk factors be offered or referred to intensive behavioral counseling interventions to promote a healthful diet and physical activity for CVD prevention.

Hypothesis: We hypothesized that primary care providers (PCPs) who discussed physical activity with most of their at risk patients would have a higher prevalence of offering select components than PCPs who discussed physical activity less frequently.

Methods: DocStyles 2015, a Web-based panel survey of 1251 PCPs (response rate=76.8%), assessed physical activity counseling practices with patients at risk for CVD (overweight or obese and with hypertension, dyslipidemia, impaired fasting glucose, or the metabolic syndrome).

Results: Overall, 55.9% (SE=1.4) of PCPs discussed physical activity with most of their patients at risk for CVD. Among respondents who discussed physical activity with any at risk patients (N=1244), the prevalence of components offered when they counseled ranged from 92.6% encouraging increased physical activity to 15.8% referring to intensive behavioral counseling (Table). PCPs who discussed physical activity with most at risk patients had a higher prevalence of offering all counseling components assessed than PCPs who discussed physical activity less frequently, except for referring to intensive behavioral counseling where no difference was found. Of all PCPs, 8.4% both discussed physical activity with most of their at risk patients and referred them to intensive behavioral counseling.

Conclusion: Just over half of PCPs surveyed discussed physical activity with most patients at risk for CVD. These PCPs more frequently offered select components when they counseled with the exception of referral to intensive behavioral counseling. Both the low levels of counseling and referral to intensive behavioral counseling present important opportunities for improving counseling practices.

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