Lifestyle behaviours are the largest group of preventable risk factors in Australia. Of all the patients who attend a general practice, about half are overweight, two thirds have a low level of physical activity, one-fifth are smokers and another one fifth drink alcohol at risky levels. Yet the benefits of addressing lifestyle risk factors, to both the patient’s health and our overloaded health care system, are enormous – but you can’t do all the work yourself.

Consulting with your patient
Provide the patient with the opportunity to assess themselves by asking them to complete the appropriate Lifescripts Risk Factor assessment form. Review of the assessment can then form the basis of the lifestyle intervention. Allow the patient to explore their own ambivalence, encouraging them to talk about any problems related to the risk factor and the benefits they would receive by implementing change. It may be useful to assess how confident or motivated they may feel about any adjustments to their lifestyle on a scale of 1 to 5, to determine how ready they are and whether they are likely to relapse into old habits.

After spending time listening to and prompting the patient, summarise the information they have provided as a basis for the prescription process. You’ll need to prescribe what is achievable, knowing that you and the patient can work towards the evidence based recommendations down the track. It’s important for the patient to see that change is possible and to be confident in their own capacity to change. Now it’s time to arm them with a few relevant resources and some useful advice. Encourage them to take the information home and read through any leaflets at their leisure.

Now they’re ready to leave the surgery, but are they ready for success? It’s important to follow up on any lifestyle interventions to motivate your patient towards the required change. Try booking them in for a follow up appointment. Patients may be reluctant to do this, but perhaps you can preface the request by saying “I would really like to talk to you more about this, but we’ve run out of time - let’s make another appointment”. Or perhaps your practice nurse could do a follow up phone call three or four days later to see how the patient is going, and then if they need a further intervention, make a second appointment. And remember just because a patient has relapsed after the first brief intervention doesn’t mean it isn’t worth addressing the issue at a future date - studies show that brief interventions at a general practice level do reduce lifestyle related risk.

Lifescripts resources
Every practice is able to order one practice kit, complete with a manual to help you get started and a CD-rom containing a training module on motivational interviewing. Risk factor kits are available to each GP and they contain patient self-assessment and prescription pads, as well as clinical guidelines for the five risk factors. Practice nurses are also encouraged to order a risk factor kit. Once you have the kits, you can replenish resource supplies direct from the Department of Health and Ageing using the order form supplied in the practice manual.

Both the practice and the risk factor kits are now in stock, so if you have any further questions or would like a kit delivered to your practice, contact one of your friendly practice liaison officers – myself, Kerry or Angela – on (02) 6622 4453.

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

Lifescripts is supported and promoted by the Northern Rivers Division of General Practice.