Obesity management in Australian primary care: where has the general practitioner gone?
Elizabeth Ann Sturgiss A F , Chris van Weel B C , Lauren Ball D , Sarah Jansen E and Kirsty Douglas A
+ Author Affiliations
- Author Affiliations
A Academic Unit of General Practice, Australian National University Medical School, Canberra Hospital Campus, Building 4, Level 2, PO Box 11, Woden, ACT 2606, Australia.
B Department of Health Services Research and Policy, Australian National University, Building 62, Mills Road, Acton, ACT 2601, Australia.
C Radboud University Medical Center, Radboud University, Comeniuslaan 4, NL-6525 HP Nijmegen, Netherlands.
D Menzies Health Institute Queensland, Griffith University, Parklands Drive, Southport, Qld 4222, Australia.
E School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Parklands Drive, Southport, Qld 4222, Australia.
F Corresponding author. Email: elizabeth.sturgiss@anu.edu.au
Australian Journal of Primary Health 22(6) 473-476 https://doi.org/10.1071/PY16074
Submitted: 14 June 2016 Accepted: 24 September 2016 Published: 7 November 2016
Abstract
Obesity is a chronic condition with significant health and economic consequences that requires more effective management in Australia. General practitioners (GPs) currently act as care co-ordinators in line with national guidelines for overweight and obesity. Australian patients indicate that they would appreciate more involvement from their GP in the management of obesity, and this is in line with international findings. Not all patients have access to specialist obesity services or affordable allied health care because of location, cost and time, particularly in rural and remote areas where there is a greater prevalence of obesity. Empowering GPs to use their skills as expert generalists to manage obesity is an option that should be explored to improve access for all individuals. GPs will require evidence-based tools to assist them in structuring obesity management within their own general practice environment.
References
Arai L, Panca M, Morris S, Curtis-Tyler K, Lucas P, Roberts H (2015) Time, monetary and other costs of participation in family-based child weight management interventions: qualitative and systematic review evidence. PLoS One 10, e0123782| Time, monetary and other costs of participation in family-based child weight management interventions: qualitative and systematic review evidence.Crossref | GoogleScholarGoogle Scholar |
Australian Bureau of Statistics (2013) 4839.0 – patient experiences in Australia: summary of findings, 2012–13: general practitioners. (Australian Bureau of Statistics: Canberra, ACT, Australia) Available at http://www.abs.gov.au/AUSSTATS/abs@.nsf/Previousproducts/4839.0Main%20Features32012-13?opendocument&tabname=Summary&prodno=4839.0&issue=2012-13&num=&view= [Verified August 2016]
Ball L, Desbrow B, Leveritt M (2014) An exploration of individuals’ preferences for nutrition care from Australian primary care health professionals. Australian Journal of Primary Health 20, 113–120.
| An exploration of individuals’ preferences for nutrition care from Australian primary care health professionals.Crossref | GoogleScholarGoogle Scholar |
Britt H, Miller G, Henderson J, Bayram C, Harrison C, Valenti L, Wong C, Gordon J, Pollack A, Pan Y, Charles J (2014) General practice activity in Australia 2013–14. General Practice Series Number 36. Sydney University Press, Sydney, NSW, Australia.
Chen L, Magliano DJ, Balkau B, Wolfe R, Brown L, Tonkin AM, Zimmet PZ, Shaw JE (2011) Maximising efficiency and cost-effectiveness of type 2 diabetes screening: the AusDiab Study. Diabetic Medicine 28, 414–423.
| Maximising efficiency and cost-effectiveness of type 2 diabetes screening: the AusDiab Study.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC3MvltVKgsA%3D%3D&md5=468b120df5ddb6a14fe2ad99a4535617CAS |
Crowley J, Ball L, Yeo HD, McGill A-T, Arroll B, Leveritt M, Wall C (2015) Doctors’ attitudes and confidence towards providing nutrition care in practice: comparison of New Zealand medical students, general practice registrars and general practitioners. Journal of Primary Health Care 7, 244–250.
Fildes A, Charlton J, Rudisill C, Littlejohns P, Prevost T, Gulliford MC (2015) Probability of an obese person attaining normal body weight: cohort study using electronic health records. American Journal of Public Health 105, e54–e59.
| Probability of an obese person attaining normal body weight: cohort study using electronic health records.Crossref | GoogleScholarGoogle Scholar |
Foster MM, Cornwell PL, Fleming JM, Mitchell GK, Tweedy SM, Hart AL, Haines TP (2009) Better than nothing? Restrictions and realities of enhanced primary care for allied health practitioners. Australian Journal of Primary Health 15, 326–334.
| Better than nothing? Restrictions and realities of enhanced primary care for allied health practitioners.Crossref | GoogleScholarGoogle Scholar |
Gray DP, Evans P, Sweeney K, Lings P, Seamark D, Seamark C, Dixon M, Bradley N (2003) Towards a theory of continuity of care. Journal of the Royal Society of Medicine 96, 160–166.
| Towards a theory of continuity of care.Crossref | GoogleScholarGoogle Scholar |
Harris MF, Zwar NA (2007) Care of patients with chronic disease: the challenge for general practice. Medical Journal of Australia 187, 104–107.
Hiddink GJ, Hautvast JG, van Woerku CM, Fieren CJ, van’t Hof MA (1997) Consumers’ expectations about nutrition guidance: the importance of primary care physicians. The American Journal of Clinical Nutrition 65, 1974–1979.
Kaner EFS, Dickinson HO, Beyer FR, Campbell F, Schlesinger C, Heather N, Saunders JB, Burnand B, Pienaar ED (2007) Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database of Systematic Reviews CD004148
| Effectiveness of brief alcohol interventions in primary care populations.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2s3jsVajtQ%3D%3D&md5=e70a6f20d117b16b11ac42ff800a0f09CAS |
Kidd M (2013) Meeting people’s health needs. In ‘The Contribution of Family Medicine to Improving Health Systems: a Guidebook from the World Organization of Family Doctors’. (Ed. M Kidd) pp. 1–13. (Radcliffe Publishing: London, UK)
Mathus-Vliegen L, Toouli N (2011) World Gastroenterology Organisation Global Guideline: Obesity. (World Gastroenterology Organisation) Available at http://www.worldgastroenterology.org/UserFiles/file/guidelines/obesity-english-2011.pdf [Verified 10 June 2016]
McRae I, Yen L, Gillespie J, Douglas K (2011) Patient affiliation with GPs in Australia – who is and who is not and does it matter? Health Policy 103, 16–23.
| Patient affiliation with GPs in Australia – who is and who is not and does it matter?Crossref | GoogleScholarGoogle Scholar |
National Health and Medical Research Council (2013) Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. (National Health and Medical Research Council: Melbourne, Vic., Australia)
National Rural Health Alliance (2004) Under pressure and under-valued: allied health professionals in rural and remote areas. (National Rural Health Alliance) Available at http://ruralhealth.org.au/sites/default/files/position-papers/position-paper-04-11-05.pdf [Verified 10 June 2016]
New Zealand Guidelines Group (2012) ‘New Zealand Primary Care Handbook 2012.’ (New Zealand Guidelines Group: Wellington, New Zealand)
Pearce-Brown CL, Grealish L, McRae IS, Douglas KA, Yen LE, Wells RW, Wareham S (2011) A local study of costs for private allied health in Australian primary health care: variability and policy implications. Australian Journal of Primary Health 17, 131–134.
| A local study of costs for private allied health in Australian primary health care: variability and policy implications.Crossref | GoogleScholarGoogle Scholar |
Reeve J, Blakeman T, Freeman GK, Green LA, James PA, Lucassen P, Martin CM, Sturmberg JP, van Weel C (2013) Generalist solutions to complex problems: generating practice-based evidence – the example of managing multi-morbidity. BMC Family Practice 14, 112
| Generalist solutions to complex problems: generating practice-based evidence – the example of managing multi-morbidity.Crossref | GoogleScholarGoogle Scholar |
Stange KC (2009a) A science of connectedness. Annals of Family Medicine 7, 387–395.
| A science of connectedness.Crossref | GoogleScholarGoogle Scholar |
Stange KC (2009b) The problem of fragmentation and the need for integrative solutions. Annals of Family Medicine 7, 100–103.
| The problem of fragmentation and the need for integrative solutions.Crossref | GoogleScholarGoogle Scholar |
Starfield B (2011) Is patient-centred care the same as person-focused care? The Permanente Journal 15, 63–69.
| Is patient-centred care the same as person-focused care?Crossref | GoogleScholarGoogle Scholar |
Stead LF, Buitrago D, Preciado N, Sanchez G, Hartmann-Boyce J, Lancaster T (2013) Physician advice for smoking cessation. Cochrane Database of Systematic Reviews 2013, CD000165
Swinburn B, Egger G, Raza F (1999) Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity. Preventive Medicine 29, 563–570.
| Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3c%2FntVWqsw%3D%3D&md5=702e1852e16c4c7893a12c2afba9d716CAS |
Tan D, Zwar N, Dennis S, Vagholkar S (2006) Weight management in general practice: what do patients want? Medical Journal of Australia 185, 73–75.
van Weel C, Hiddink G, van Binsbergen J, Brotons C, Drenthen T, Green L, Halsted C, Koelen M, Kok F, Mathus-Vliegen E, Ockhuizen T, Truswell A (2008) The Fifth International Heelsum Workshop ‘more synergy between primary care and public health’: mission statement. Family Practice 25, i6
| The Fifth International Heelsum Workshop ‘more synergy between primary care and public health’: mission statement.Crossref | GoogleScholarGoogle Scholar |
Volker N, Clancy T, Cochrane T, Davey R (2014) HeartLink final report. University of Canberra, Centre for Research and Action in Public Health, Canberra, ACT, Australia.
Wadden TA, Butryn ML, Hong PS, Tsai AG (2014) Behavioral treatment of obesity in patients encountered in primary care settings: a systematic review. Journal of the American Medical Association 312, 1779–1791.
| Behavioral treatment of obesity in patients encountered in primary care settings: a systematic review.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC2cXitVyqu73K&md5=695fc6b45ef201249beec86dfd9c65feCAS |
