Lifestyle advice in general practice: Rates recalled by patients

Objective - To document how often patients with varying cardiovascular risk levels reported receiving lifestyle advice from general practice. Design - Cross sectional descriptive survey by postal questionnaire. Setting - 5 general practices in Bedfordshire. Subjects - 4,941 people aged 35-64 years who had consulted a general practitioner at least once during the 12 months before completing the questionnaire and who subsequently attended for a health check as part of the OXCHECK trial. Main outcome and measures - Report of having received advice from a general practitioner or practice nurse about smoking, alcohol consumption, exercise, or diet during the 12 months before completing the questionnaire. Cardiovascular risk assessed by a nurse during structured health check. Results - The overall reported rate of advice was 27% for smoking, 4.5% for exercise, 12% for diet, and 3% for alcohol consumption. Those with unhealthy behaviour profile or at increased cardiovascular risk received more advice - for example, 47% of smokers with a history of cardiovascular disease received advice on smoking. Among those at increased risk, men were more likely than women to receive advice about exercise (11% v 4%, p = 0.04) and alcohol consumption (10% v 4%, p = 0.007), while women received more advice about weight (17% v 23%, p < 0.001). The rate of receiving advice was unaffected by age, marital status, or social class. Conclusion - The low rate of lifestyle advice reported by patients implies that more preventive advice could be provided in primary care.