Lifescripts was launched by Tony Abbott in September and forms part of the “Focus on Prevention” package introduced in the 2003-04 Federal Budget, which also includes the National Primary Care Collaboratives program (NPCC).

The idea behind Lifescripts is to build a national approach to raising awareness of the role of health professionals in preventative health, and to provide consistent, high quality patient education materials. Lifescripts is a response to studies that show patients need healthy lifestyle advice tailored to their individual needs and that even an extra minute added to a consultation can reduce lifestyle related risk.

Lifescripts provides a framework and the tools for GPs, practice nurses, Aboriginal health workers and practice staff to address five patient lifestyle risk factors that may lead to or complicate chronic disease. The five factors are smoking, alcohol use, nutrition, physical inactivity and weight management.

The resources in the Lifescripts kits may be used to focus on one risk factor at a time or all five at once. In fact the flexibility of the kits means they can be adapted to individual practice needs, either by accessing the resources opportunistically as a patient presents with lifestyle related symptoms, or by using the practice recall and reminder system to target certain patients and their conditions, and link in with current health promotions or availability of allied health professionals.

Lifestyle risk factors
Smoking causes more death and disease in Australia than any other risk factor, while quitting produces both immediate and long term benefits for the patient.

It is estimated that one in five patients who present to a GP is a smoker, and surveys show patients largely underestimate their smoking rate to their doctor. 6% of Australians have an alcohol use disorder, again one in five patients engage in risky drinking behaviour, such as binge drinking.

Surprisingly for women, the biggest cause of death and disability is physical inactivity, yet only 30 minutes of moderate exercise a day reduces the risk of mortality, chronic disease and mental illness. The role of good nutrition and achieving an optimal weight is well documented, and GPs are in a prime position to address both factors with 50% of presenting patients being at risk of developing medical conditions directly caused by being overweight.

Assessment and intervention
The resource kits provide a practice manual, including a CD-ROM, to provide education for the whole of the practice and assistance to develop a plan of action. Posters and brochures are included for the waiting room, as well as a simple assessment that can be completed by the patient before going in to their consultation.

As with all the resources, the assessment and accompanying guidelines are evidence based and provide a starting point from which a GP or practice nurse could provide a brief (3-5 minute) intervention to assist patients to address their lifestyle risk factor.

The intervention process could begin with motivational interviewing to assess the patient’s willingness and confidence to change, using the ‘five As approach – Ask, Assess, Advise, Assist and Arrange.
1. ASK patients about their lifestyle risk factors to identify who is at risk.

2. ASSESS the level of their risk and relevance to their current health using the Lifescripts assessment pads.

3. PROVIDE brief Advice on healthier choices, accompanied by relevant written information to take home.

4. ASSIST the patient by using the Lifescripts prescription pad, which helps to provide achievable goals for behavioural change. Lifestyle prescriptions work because patients are used to leaving the practice with a prescription if the GP feels it is necessary. They have an automatic behavioural response to scripts and are therefore more likely to comply with the suggested changes.

5. ARRANGE referral to any services or groups that support healthy lifestyle choices. It is also important to use your practice recall and reminder system to provide ongoing reviews, follow-up support and regular encouragement sessions for patients.

Lifescripts promotion
The Federal funding for Lifescripts also includes an advertising campaign to raise public awareness and stimulate patient demand, and recently Dr Rob Walters and Tony Abbott spoke about Lifescripts on ‘Mornings with Kerri-Anne Kennerley’ (Channel Nine).

For more information, try the Australian Division of General Practice (ADGP) website at www.adgp.com.au or the Department of Health & Ageing (DoHA) website at www.health.gov.au (type “Lifestyle Prescriptions” into their search engine).

If you have any further questions or would like to order the practice resource kits, please contact your friendly practice liaison officer on 6622 4453. While at the moment stocks of the practice kits are low to due to a higher than expected national demand, stocks will be replenished by February and we can place your name on backorder.

Therese Greenlees is one of the division’s practice liaison officers: tgreenlees@nrdgp.org.au