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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Nutrition advice in general practice: the role of general practitioners and practice nurses

Lana J. Mitchell A C , Lesley MacDonald-Wicks A and Sandra Capra B
+ Author Affiliations
- Author Affiliations

A Faculty of Health, School of Health Sciences, University of Newcastle, Hunter Building, University Drive, Callaghan, NSW 2308, Australia.

B Centre for Clinical Research, The University of Queensland, Building 16/712, Royal Brisbane and Women’s Hospital, Herston, Qld 4029, Australia.

C Corresponding author. Email: lana.mitchell@newcastle.edu.au

Australian Journal of Primary Health 17(2) 202-208 https://doi.org/10.1071/PY10101
Submitted: 1 December 2010  Accepted: 9 March 2011   Published: 7 June 2011

Abstract

General practice is an ideal setting to be providing nutrition advice; however, it is important that the role of general practitioners (GPs) and practice nurses in providing nutrition advice is acknowledged and defined. This article aims to discuss the role of GPs and practice nurses in the delivery of nutrition advice. Ten general practitioners and 12 practice nurses from a NSW urban Division of General Practice participated in questionnaires and a Lifescripts© implementation study, as well as their consenting patients receiving Lifescripts© (n = 13). An online survey was conducted with 90 Australian private practice dietitians. Semi-structured telephone interviews were conducted with 52 Australian private practice dietitians. The provision of basic nutrition advice is acknowledged to be part of the role of GPs and practice nurses, as they are the first point of contact for patients, allowing them to raise nutrition awareness. However, it is important that this advice is evidence based and able to be delivered in a time-efficient manner. Increased nutrition education and the availability of appropriate resources and nutrition-related best practice guidelines will assist in this process.

Additional keywords: dietetics, nutrition therapy.


References

American Dietetic Association (1998) Position of the American Dietetic Association: Nutrition education for health care professionals. Journal of the American Dietetic Association 98, 343–346.
Position of the American Dietetic Association: Nutrition education for health care professionals.Crossref | GoogleScholarGoogle Scholar | 9508021PubMed |

Ammerman AS, DeVellis RF, Carey TS, Keyserling TC, Strogatz DS, Haines PS, Simpson RJ, Siscovick DS (1993) Physician-based diet counseling for cholesterol reduction: Current practices, determinants, and strategies for improvement. Preventive Medicine 22, 96–109.
Physician-based diet counseling for cholesterol reduction: Current practices, determinants, and strategies for improvement.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK3s3jsVCjtA%3D%3D&md5=bc69ca0c4bf88ff9bd7264b5bb2abe82CAS | 8475015PubMed |

Amoroso C, Hobbs C, Harris M (2005) General practice capacity for behavioural risk factor management: A snap-shot of a needs assessment in Australia. Australian Journal of Primary Health 11, 120–127.
General practice capacity for behavioural risk factor management: A snap-shot of a needs assessment in Australia.Crossref | GoogleScholarGoogle Scholar |

Australian Institute of Health and Welfare (2010) ‘Australia’s health 2010.’ (AIHW: Canberra)

Ball LE, Hughes RM, Leveritt MD (2010) Nutrition in general practice: Role and workforce preparation expectations of medical educators. Australian Journal of Primary Health 16, 304–310.
Nutrition in general practice: Role and workforce preparation expectations of medical educators.Crossref | GoogleScholarGoogle Scholar | 21138698PubMed |

Bonevski B, Sanson-Fisher RW, Campbell EM (1996) Primary care practitioners and health promotion: A review of current practices. Health Promotion Journal of Australia 6, 22–31.

Brauer P, Dietrich L, Davidson B (2006) Nutrition in primary health care: Using a Delphi process to design new interdisciplinary services. Canadian Journal of Dietetic Practice and Research S14–S29.
Nutrition in primary health care: Using a Delphi process to design new interdisciplinary services.Crossref | GoogleScholarGoogle Scholar | 17020639PubMed |

Britt H, Miller GC, Knox S, Charles J, Pan Y, Henderson J, Bayram C, Valenti L, Ng A, O’Halloran J (2005) ‘General practice activity in Australia 2004–05.’ General Practice Series No. 18. (Australian Institute of Health and Welfare: Canberra)

Britt H, Miller GC, Charles J, Henderson J, Bayram C, Pan Y, Valenti L, Harrison C, Fahridin S, O’Halloran J (2009) ‘General practice activity in Australia 2008–09.’ (Australian Institute of Health and Welfare: Canberra)

Cadman L, Findlay A (1998) Assessing practice nurses’ change in nutrition knowledge following training from a primary care dietitian. The Journal of the Royal Society for the Promotion of Health 118, 206–209.
Assessing practice nurses’ change in nutrition knowledge following training from a primary care dietitian.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1M7nsF2ltg%3D%3D&md5=fc90942610fa63ebd3f80bd9471ed646CAS | 10076668PubMed |

Campbell K, Engel H, Timperio A, Cooper C, Crawford D (2000) Obesity management: Australian general practitioners’ attitudes and practices. Obesity Research 8, 459–466.
Obesity management: Australian general practitioners’ attitudes and practices.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3cvltlKlsA%3D%3D&md5=0734d7e00e2d19083adee64bc8b6e802CAS | 11011913PubMed |

Cant R, Aroni R (2007) Melbourne dietitians’ experience of Medicare policy on allied health services (strengthening Medicare; enhanced primary care) in the first 12 months. Nutrition & Dietetics 64, 43–49.
Melbourne dietitians’ experience of Medicare policy on allied health services (strengthening Medicare; enhanced primary care) in the first 12 months.Crossref | GoogleScholarGoogle Scholar |

Conroy M, Shannon W (1995) Clinical guidelines: Their implementation in general practice. The British Journal of General Practice 45, 371–375.

Department of Health and Ageing (2010a) ‘Lifescripts.’ (Canberra) Available at http://www.health.gov.au/lifescripts [Verified 4 February 2010]

Department of Health and Ageing (2010b) ‘MBS primary care items: Individual allied health services for patients with a chronic medical condition and complex care needs under Medicare.’ Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/mbsprimarycare-chronicdiseasemanagement [Verified 2 July 2010]

Glanz K (1997) Review of nutritional attitudes and counseling practices of primary care physicians. The American Journal of Clinical Nutrition 65, 2016S–2019S.

Hegney D, Eley R, Buikstra E, Rees S, Patterson E (2006) Consumers’ level of comfort with an advanced practice role for registered nurses in general practice: A Queensland, Australia, study. Australian Journal of Primary Health 12, 44–51.
Consumers’ level of comfort with an advanced practice role for registered nurses in general practice: A Queensland, Australia, study.Crossref | GoogleScholarGoogle Scholar |

Hiddink GJ, Hautvast JG, van Woerkum CM, Fieren CJ, van ‘t Hof MA (1995) Nutrition guidance by primary-care physicians: Perceived barriers and low involvement. European Journal of Clinical Nutrition 49, 842–851.

Hummers-Pradier E, Scheidt-Nave C, Martin H, Heinemann S, Kochen MM, Himmel W (2008) Simply no time? Barriers to GPs’ participation in primary health care research. Family Practice 25, 105–112.
Simply no time? Barriers to GPs’ participation in primary health care research.Crossref | GoogleScholarGoogle Scholar | 18417465PubMed |

Kushner RF (1995) Barriers to providing nutrition counseling by physicians: A survey of primary care practitioners. Preventive Medicine 24, 546–552.
Barriers to providing nutrition counseling by physicians: A survey of primary care practitioners.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK287pslGksw%3D%3D&md5=f126b257a135b6c15be57638f40e3d56CAS | 8610076PubMed |

Macario E, Emmons KM, Sorensen G, Hunt MK, Rudd RE (1998) Factors influencing nutrition education for patients with low literacy skills. Journal of the American Dietetic Association 98, 559–564.
Factors influencing nutrition education for patients with low literacy skills.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1c3lvFeitQ%3D%3D&md5=c4e52f5e807297222e2cc0bc61b4bf84CAS | 9597029PubMed |

Mitchell LJ, MacDonald-Wicks L, Capra S (2011) Increasing dietetic referrals – perceptions of general practioners, practice nurses and dietitians. Nutrition & Dietetics (awaiting publication).

Nicholas LG, Pond CD, Roberts DC (2003) Dietitian-general practitioner interface: A pilot study on what influences the provision of effective nutrition management. The American Journal of Clinical Nutrition 77, 1039S–1042S.

Nicholas L, Pond D, Roberts DC (2004) GPs’ views on active nutrition management for their patients. Australian Family Physician 33, 957–958.

Phillips CB, Pearce CM, Hall S, Kljakovic M, Sibbald B, Dwan K, Porritt J, Yates RE (2009) Enhancing care, improving quality: The six roles of the general practice nurse. The Medical Journal of Australia 191, 92–97.

Pineiro R, Brotons C, Bulc M, Ciurana R, Drenthen T, Durrer D, Godycki-Cwirko M, Gorpelioglu S, Kloppe P, Lionis C, Mancini M, Martins C, Mierzecki A, Pichler I, Pullerits L, Sammut MR, Sghedoni D, Sheehan M, Thireos EA (2005) Healthy diet in primary care: Views of general practitioners and nurses from Europe. European Journal of Clinical Nutrition 59, S77–S80.
Healthy diet in primary care: Views of general practitioners and nurses from Europe.Crossref | GoogleScholarGoogle Scholar | 16052199PubMed |

Pomeroy SEM, Cant RP (2010) General practitioners’ decision to refer patients to dietitians: Insight into the clinical reasoning process. Australian Journal of Primary Health 16, 147–153.
General practitioners’ decision to refer patients to dietitians: Insight into the clinical reasoning process.Crossref | GoogleScholarGoogle Scholar | 21128576PubMed |

Pomeroy SE, Worsley A (2009) Enhancing the dietary management of general practice patients through collaborative care: Perspectives of general practitioners and dietitians. Nutrition & Dietetics 66, 81–86.
Enhancing the dietary management of general practice patients through collaborative care: Perspectives of general practitioners and dietitians.Crossref | GoogleScholarGoogle Scholar |

Primary Health Care Research and Information Service (2006) ‘Key division of general practice characteristics 2004–2005.’ Available at http://www.phcris.org.au/products/asd/other/KeyDGPstatistics0405.xls [Verified 12 September 2006]

Raftery JP, Yao GL, Murchie P, Campbell NC, Ritchie LD (2005) Cost effectiveness of nurse led secondary prevention clinics for coronary heart disease in primary care: Follow up of a randomised controlled trial. British Medical Journal 330, 707
Cost effectiveness of nurse led secondary prevention clinics for coronary heart disease in primary care: Follow up of a randomised controlled trial.Crossref | GoogleScholarGoogle Scholar | 15716289PubMed |

Sims J, Tacticos T, Potiriadis M, Naccarella L (2004) Evaluation of a program to assist usage of the enhanced primary care case conferencing and care planning items: The allied health professionals’ viewpoint. Australian Journal of Primary Health 10, 72–77.
Evaluation of a program to assist usage of the enhanced primary care case conferencing and care planning items: The allied health professionals’ viewpoint.Crossref | GoogleScholarGoogle Scholar |

Tan D, Zwar NA, Dennis SM, Vagholkar S (2006) Weight management in general practice: What do patients want? The Medical Journal of Australia 185, 73–75.

The Royal Australian College of General Practitioners (1998) ‘Putting prevention into practice: A guide for the implementation of prevention in the general practice setting.’ (Royal Australian College of General Practitioners: Melbourne)

Truswell AS, Hiddink GJ, Blom J (2003) Nutrition guidance by family doctors in a changing world: Problems, opportunities, and future possibilities. The American Journal of Clinical Nutrition 77, 1089S–1092S.

Watts I, Foley E, Hutchinson R, Pascoe T, Whitecross L, Snowdon T (2004) ‘General practice nursing in Australia.’ (Royal Australian College of General Practitioners and Royal College of Nursing, Australia) .

Witt J, Brauer P, Dietrich L, Davidson B (2006) Estimation of human resource needs and cost of adding registered dietitians to primary care networks. Canadian Journal of Dietetic Practice and Research 67, S30–S38.
Estimation of human resource needs and cost of adding registered dietitians to primary care networks.Crossref | GoogleScholarGoogle Scholar |