Evidence
Alert

Most patients welcome advice from GPs on changing their behaviour to improve health

Most patients are open to receiving advice on behaviour change from their GP. That is especially true if the advice is personally tailored and relevant to their illness. A good doctor-patient relationship is also important for the way advice is given and received.

The findings come from interviews with people about their experiences of receiving this advice from GPs. Previous research has shown that many GPs worry that people do not want such advice. It has found that GPs may not provide advice to everyone who might benefit from changing their behaviour.

This study suggests GPs can be reassured that their interventions are mostly welcomed and seen as helpful. It would be useful to see more research about what works best to help patients achieve healthy changes to their lifestyles.

What’s the issue?

Behaviour change advice includes helping people to quit smoking, lose weight, be more physically active and eat a healthier diet. These changes can help to prevent or to improve recovery from health conditions such as diabetes, cancer and cardiovascular disease.

NHS England encourages GPs to provide advice to help people change their health behaviours. But many GPs fear this advice will be unwelcome. Perhaps as a result, a 2018 survey by the same research group found that GPs offer advice to only one third of patients they believe could benefit from it.

This study was set up to find out what patients think about being offered behaviour change advice as part of a routine GP consultation.

What’s new?

24 people were asked about their experiences of receiving behaviour change advice.

The study found that:

  • people are generally positive about GPs offering behaviour change advice as part of routine GP consultations
  • behaviour change advice is seen as a sensitive topic, but people think a good doctor-patient relationship can encourage these conversations and they saw doctors as appropriate people to give the advice
  • specific information that is relevant to the patient’s condition and tailored to them personally is more useful than general advice.

Interviewees believe that health advice could give them the autonomy to take control of their own health. It is particularly welcomed where behaviour change could have a positive effect on a long-term condition.

They said barriers to successful communication include a lack of regular contact with their GP. This limits the opportunities for discussion about behaviour change. A ‘preaching’ style of communication is to be avoided in favour of approaches tailored to patients.

Overall, GPs were seen as trusted and positive role models. Behaviour change messages from GPs carried more weight than the same messages from other sources.

Why is this important?

GPs have been encouraged to provide lifestyle advice to patients for years, but recent surveys suggest many do not do so. This could be because they worry it will not be well-received.

This research suggests most people welcome behaviour change advice from their GP if it is specific and relevant to their condition. Providing advice to more people could be a worthwhile use of GPs’ time.

NHS England supports an initiative called Making Every Contact Count. It encourages health service staff to offer behaviour change advice and support at any appropriate opportunity. These study results suggest that GPs could make more of these opportunities.

What’s next?

More research into the behavioural change techniques that are most effective would be helpful. The research could include developing and testing brief interventions that GPs can deliver to patients in a short consultation. It could also look at health promotion resources which could prompt conversations about behaviour change during consultations.

Most of the people in the study were older and had a long-term medical condition. These people may be more interested in receiving behaviour change advice. Future research could look at the attitudes of younger people without medical conditions.

The study is part of a larger project examining the experiences of both patients and healthcare professionals. They are identifying barriers that stop behaviour change advice from being a routine part of treatment for all patients.

You may be interested to read

The full paper: Keyworth C, and others. Perceptions of receiving behaviour change interventions from GPs during routine consultations: A qualitative study. PLoS ONE 2020;15:e0233399

A consensus statement on the Making Every Contact Count (MECC) initiative

Information about implementing MECC

Information about evaluating MECC

A blog by the lead researcher of this paper, outlining the opportunities for healthcare professionals to engage with public health policy

Funding

This study was funded by Tesco Plc and supported by the NIHR Manchester Biomedical Research Centre and the NIHR Greater Manchester Patient Safety Translational Research Centre. Tesco had no role in the study design, execution, analyses, interpretation and storage of the data, or decision to submit results.

Commentaries

Study author

The findings provide an interesting contrast to what we already know. The expectation that GPs should deliver behaviour change interventions is not new. But GPs are often ambivalent about their role in providing behaviour change interventions, and are sceptical of patient receptivity to advice. Our findings show that patients would welcome such discussions in particular circumstances.

Behaviour change interventions delivered by GPs during routine medical consultations allow interventions to have maximum reach, and can be used effectively when incorporated into time-restricted consultations. A more proactive approach to behaviour change could be adopted in patient consultations with the broad approval of patients.

Chris Keyworth, Research Fellow, Manchester Centre for Health Psychology, University of Manchester

Member of the public

Some patients will be resistant to receiving advice that they do not want to hear. This tends to suggest they will receive the advice with good intention but then go home and carry on eating and drinking as before.

I believe this research topic has merits. But commissioners and GPs will have to resource the time involved in the consultation plus any follow up with patients. Accurate measurement of any improvements in health will determine what impact this project has on policy.

Ian Prince, Lincoln

Conflicts of Interest

None declared.