Patients' need for more counseling on diet, exercise, and smoking cessation: Results from the National Ambulatory Medical Care Survey
Patients' need for more counseling on diet, exercise, and smoking cessation: Results from the National Ambulatory Medical Care Survey
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DOI：
10.1331/154434506777069516
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发表时间：
2006-05-01
影响因子：
2.1
通讯作者：
Frede, Stacey M.
中科院分区：
文献类型：
--
作者：
Heaton, Pamela C.;Frede, Stacey M.
目的：确定在2002年全国门诊医疗调查（NAMCS）中报告在门诊访视期间就饮食/营养、运动、减肥或戒烟向患者提供咨询的医生的百分比。我们试图建立患者是否接受足够的咨询医生的基础上，这项全国性的调查。设计：回顾性数据库分析。设置。参加国：数据包括诊断为2型糖尿病、高脂血症、高血压或肥胖的患者的184，668，007次医生就诊;处方胰岛素/口服降糖药、抗高脂血症药物、血管紧张素转换酶抑制剂、噻嗪类利尿剂或减肥药物的患者的140，362，102次医生就诊;和82，317，640名吸烟或使用烟草的患者的医生就诊。干预措施：不适用。主要结果测量：对有关饮食/营养、锻炼、减肥和烟草使用/暴露的咨询/教育/治疗的反应频率。结果：对于患有2型糖尿病、高脂血症或高血压的患者，或接受可能表明存在这些疾病的药物类别之一的药物的患者，患者在超过一半的访视期间未接受任何类型的饮食或运动咨询。被诊断为肥胖的患者最有可能接受任何类型的咨询（80.2%）。谁使用烟草的患者的访问，78.6%不包括任何咨询戒烟。结论：患者没有足够的咨询和教育的需要，生活方式的改变，可以影响他们的常见慢性病的风险。作为方便和理想的医疗保健提供者，药剂师可以通过填补这一空白来影响肥胖和其他生活方式相关疾病的流行。
Objective: To determine the percentage of physicians who reported counseling patients on diet/nutrition, exercise, weight reduction, or smoking cessation during their office visits when responding to the 2002 National Ambulatory Medical Care Survey (NAMCS). We sought to establish whether patients are receiving adequate counseling from physicians on the basis of this nationwide survey.Design: Retrospective database analysis.Setting. United States.Participants: Data included 184,668,007 physician visits for patients diagnosed with type 2 diabetes, hyperlipidemia, hypertension, or obesity; 140,362,102 physician visits for patients in which insulin/oral antidiabetics, antihyperlipidemia drugs, angiotensin-converting enzyme inhibitors, thiazide diuretics, or weight loss drugs were prescribed; and 82,317,640 physician visits for patients who smoked or used tobacco.Interventions: Not applicable.Main Outcomes Measures: Frequency of responses for counseling/education/therapy about diet/nutrition, exercise, weight reduction, and tobacco use/exposure.Results: For patients with type 2 diabetes, hyperlipidemia, or hypertension, or patients receiving a drug in one of the drug classes that may indicate the presence of these diseases, patients did not receive any type of diet or exercise counseling during more than one half of all visits. Visits by patients who were diagnosed as obese were most likely to receive any type of counseling (80.2%). Of visits for patients who used tobacco, 78.6% did not include any counseling about smoking cessation.Conclusion: Patients are insufficiently counseled and educated about the need for lifestyle changes that can affect their risks for common chronic diseases. As accessible and ideally positioned health care providers, pharmacists could potentially affect the rising epidemic of obesity and other lifestyle-related diseases by filling this void.