Jorgen Lous
University of Southern Denmark, Denmark
Title: Methods on how we did a patient-focused primary prevention to younger vulnerable patients in general practice, Denmark
Biography
Biography: Jorgen Lous
Abstract
Several elements have to be fulfilled to achieve a success in prevention in general practice. Motivated GPs got education: 50 (15%) of invited GPs from the County of North Jutland, Denmark participated in the 40 hour training program and 8.6% (28) recruited patient into the study. Exercise in patient-focused preventive consultation was an important part of the training. Fee for extra time: The GPs got a fee for courses and preventive health consultations. Find patients who need some intervention: A screening Questionnaire (Q33) on own resources, network, lifestyle and social conditions was completed by
2.056 patients 20-45 years old when coming to the clinic for any other reason. The 30% with most psychosocial problems (>7) were invited to participate and were randomized to control or intervention (two consultations with their GP). All had one year postal follow-up. Motivate patients who feel they need some changes in their daily life: A baseline-questionnaire (QB) with 84 questions on life conditions, health, life style and social problems was priming the participants to the patient-focused consultation. Patients might choose one or two goals for a better life. Discuss resources, barriers and time schedule for chosen changes: important to explore the patient's own agenda and resources and support self-efficacy. A 20 minutes follow-up within three months: How is it going? What is difficult and why?, support self-efficacy again and A one-year questionnaire (Q1) like QB. What has changed during the year? After one year the intervention group had significant better SF-12 mental score 4.3
(95% confidence interval), fewer problems (from 10.0 to 8.2=1.8 problems) and the overweight who had prioritized weightloss had mean weight loss of 4.73 kg (95% Cl: 1.8 to 7.7).