Putting Lifescripts into practice

by Therese Greenlees

In the last GPSpeak, you heard all about Lifescripts as a national approach to addressing preventative health care using high quality patient education materials that are evidence based. It also provides a flexible framework and the tools to address the five patient lifestyle risk factors of smoking, alcohol, nutrition, and weight management. So now you know what Lifescripts are, how do you integrate Lifescripts into your practice, especially given the critical factor of lack of time?

Getting started
Step 1: One thing at a time
Start with whatever is easiest to implement and then build from there. Do you or someone in the practice have a special interest in any of the lifestyle risk factors? Perhaps the practice has addressed one of these factors in the past, when patients present opportunistically with lifestyle related symptoms.

Is it time to revisit those factors in a systematic way, using the practice recall and reminder system or the database in your medical software? Or would you prefer to continue with opportunistic interventions, linking patients into a community program such as a local walking group or a weight management program. Whatever you decide it is easiest to address one factor at a time rather than all five at once.

Step Two: Know your patients
Start with patients you feel comfortable speaking to about lifestyle risk factors, those who are ready to change their lifestyle, and those who are used to working towards goals, such as patients currently under a GP management plan.

Does your practice population present with one of the lifestyle risk factors above all others? If weight management and nutrition are seen as a community wide issue, start there, if alcohol is the biggest problem, you already know where to start. The RACGP 3rd Edition Standards for accreditation now requires that at least 50% of health records contain a health summary (Standard 1.7), so now is a good time to update your patient’s social history and address smoking and alcohol issues at the same time.

Use your waiting room as a promotion tool
Step Three: Promoting preventative health
Prepare your patients by promoting preventative health. The Lifescripts resource kit contains posters and brochures that you can use in the waiting room, as well as assessment pads that patients can complete before their consultation. Many resources are available to address lifestyle risk factors, and most can be accessed on the web. The idea is to pick a few well used resources rather than striving for the biggest library in the Northern Rivers.

Quitline (www.quit.org.au or 137 848) is great for addressing smoking, the Heart Foundation (www.heartfoundation.com.au or 1300 305 658) can help with exercise, nutrition and weight management, while NSW Health (www.health.nsw.gov.au) is a good source of alcohol related resources.

Try linking into other promotions such as targeting smoking around “World No Tobacco Day” (31st May) or promoting physical activity during “Heart Week” (1st week of May).

Step Four: Know your referral sources
What resources are there in your community? Is there a local walking group that meets regularly, does your Community Health Centre have a drug and alcohol counsellor, where can you find an exercise physiologist? This is probably the second most difficult part of the Lifescripts process, the first being making a start.

Building a list of allied health and community support takes time, but developing a close working relationship with supportive health professionals will save you time in the long run, and your patients will benefit from the support of professionals you trust.

Step Five: Maintain enthusiasm, your own and your patient’s
Change may not happen overnight, but it will happen. Using small messages consistently in brief interventions (2-3 minutes) is proven to be most effective - perhaps the patient isn’t willing or able to make changes today but you’ve planted a seed that may bear fruit in the future. This is why it’s important to begin targeting patients who are willing to change, so you can achieve small wins early on and maintain the momentum of implementing Lifescripts into your practice.

Once you have proven systems in place, you can then tackle the more difficult task of approaching patients who have not considered lifestyle change, or who have not yet explored the idea that their lifestyle is affecting their health. And if you don’t have time to fully address a lifestyle factor during today’s consultation, encourage your patient to make another appointment – either with the GP or practice nurse.

Step Six: Use the NRDGP’s free service
If you need help getting started, help accessing resources, or if you have any further questions or would like to order the practice resource kits, you know who to call - your friendly practice liaison team on 6622 4453.

Therese Greenlees is one of the division’s practice liaison officers.