Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
권호 표지
DOI QR코드

DOI QR Code

Patients' and General Practitioners' Views About Preventive Care in Family Medicine in Switzerland: A Cross-sectional Study

  • Cohidon, Christine (Department of Family Medicine, University of Lausanne) ;
  • Imhof, Fabienne (Department of Family Medicine, University of Lausanne) ;
  • Bovy, Laure (Department of Family Medicine, University of Lausanne) ;
  • Birrer, Priska (Department of Family Medicine, University of Lausanne) ;
  • Cornuz, Jacques (Center for Primary care and Public Health (Unisante), University of Lausanne) ;
  • Senn, Nicolas (Department of Family Medicine, University of Lausanne)
  • Received : 2019.07.05
  • Accepted : 2019.09.04
  • Published : 2019.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: The aim of this study was to describe general practitioners (GPs)' opinions and practices of preventive care and patients' opinions, attitudes, and behaviors towards prevention. Methods: The data stemmed from a cross-sectional national survey on prevention conducted in Switzerland from 2015 to 2016. In total, 170 randomly drawn GPs and 1154 of their patients participated. The GPs answered an online questionnaire and the patients answered a questionnaire administrated by fieldworkers present at their practices. Results: Both patients and GPs agreed that delivering preventive care is the dedicated role of a GP. It appeared that beyond classical topics of prevention such as cardiovascular risk factors, other prevention areas (e.g., cannabis consumption, immunization, occupational risks) were scarcely covered by GPs and reported as little-known by patients. In addition, GPs seemed to use a selective approach to prevention, responding to the clinical context, rather than a systematic approach to health promotion. The results also highlight possibilities to improve prevention in family medicine through options such as more supportive tools and public advertising, more time and more delegated tasks and, finally, a more recognized role. Conclusions: Despite an unfavorable context of prevention within the healthcare system, preventive care in family medicine is reasonably good in Switzerland. However, some limitations appear regarding the topics and the circumstances of preventive care delivery. A global effort is needed to implement necessary changes, and the responsibility should be broadened to other stakeholders.

Keywords

References

  1. Wagner KH, Brath H. A global view on the development of non communicable diseases. Prev Med 2012;54 Suppl:S38-S41. https://doi.org/10.1016/j.ypmed.2011.11.012
  2. Grunfeld E, Manca D, Moineddin R, Thorpe KE, Hoch JS, Campbell-Scherer D, et al. Improving chronic disease prevention and screening in primary care: results of the BETTER pragmatic cluster randomized controlled trial. BMC Fam Pract 2013;14:175. https://doi.org/10.1186/1471-2296-14-175
  3. Tengs TO, Adams ME, Pliskin JS, Safran DG, Siegel JE, Weinstein MC, et al. Five-hundred life-saving interventions and their cost-effectiveness. Risk Anal 1995;15(3):369-390. https://doi.org/10.1111/j.1539-6924.1995.tb00330.x
  4. Klabunde CN, Lanier D, Breslau ES, Zapka JG, Fletcher RH, Ransohoff DF, et al. Improving colorectal cancer screening in primary care practice: innovative strategies and future directions. J Gen Intern Med 2007;22(8):1195-1205. https://doi.org/10.1007/s11606-007-0231-3
  5. Robson J. Screening in general practice and primary care. Br Med Bull 1998;54(4):961-982. https://doi.org/10.1093/oxfordjournals.bmb.a011741
  6. Mitchell NS, Catenacci VA, Wyatt HR, Hill JO. Obesity: overview of an epidemic. Psychiatr Clin North Am 2011;34(4):717-732. https://doi.org/10.1016/j.psc.2011.08.005
  7. Wolf AM, Woodworth KA. Obesity prevention: recommended strategies and challenges. Am J Med 2009;122(4 Suppl 1):S19-S23.
  8. Brotons C, Bjorkelund C, Bulc M, Ciurana R, Godycki-Cwirko M, Jurgova E, et al. Prevention and health promotion in clinical practice: the views of general practitioners in Europe. Prev Med 2005;40(5):595-601. https://doi.org/10.1016/j.ypmed.2004.07.020
  9. Calderon C, Balague L, Cortada JM, Sanchez A. Health promotion in primary care: how should we intervene? A qualitative study involving both physicians and patients. BMC Health Serv Res 2011;11:62. https://doi.org/10.1186/1472-6963-11-62
  10. Crabtree BF, Miller WL, Tallia AF, Cohen DJ, DiCicco-Bloom B, McIlvain HE, et al. Delivery of clinical preventive services in family medicine offices. Ann Fam Med 2005;3(5):430-435. https://doi.org/10.1370/afm.345
  11. Lawlor DA, Keen S, Neal RD. Can general practitioners influence the nation's health through a population approach to provision of lifestyle advice? Br J Gen Pract 2000;50(455):455-459.
  12. McAvoy BR. A scandal of inaction: how to help GPs implement evidence-based health promotion. Br J Gen Pract 2000;50(452):180-181.
  13. McAvoy BR, Kaner EF, Lock CA, Heather N, Gilvarry E. Our Healthier Nation: are general practitioners willing and able to deliver? A survey of attitudes to and involvement in health promotion and lifestyle counselling. Br J Gen Pract 1999;49(440):187-190.
  14. McKinlay E, Plumridge L, McBain L, McLeod D, Pullon S, Brown S. "What sort of health promotion are you talking about?": a discourse analysis of the talk of general practitioners. Soc Sci Med 2005;60(5):1099-1106. https://doi.org/10.1016/j.socscimed.2004.06.041
  15. Olesen F, Dickinson J, Hjortdahl P. General practice--time for a new definition. BMJ 2000;320(7231):354-357. https://doi.org/10.1136/bmj.320.7231.354
  16. Yarnall KS, Ostbye T, Krause KM, Pollak KI, Gradison M, Michener JL. Family physicians as team leaders: "time" to share the care. Prev Chronic Dis 2009;6(2):A59.
  17. Badertscher N, Rossi PO, Rieder A, Herter-Clavel C, Rosemann T, Zoller M. Attitudes, barriers and facilitators for health promotion in the elderly in primary care. A qualitative focus group study. Swiss Med Wkly 2012;142:w13606.
  18. Bucher S, Maury A, Rosso J, de Chanaud N, Bloy G, Pendola-Luchel I, et al. Time and feasibility of prevention in primary care. Fam Pract 2017;34(1):49-56. https://doi.org/10.1093/fampra/cmw108
  19. Cornuz J, Ghali WA, Di Carlantonio D, Pecoud A, Paccaud F. Physicians' attitudes towards prevention: importance of intervention-specific barriers and physicians' health habits. Fam Pract 2000;17(6):535-540. https://doi.org/10.1093/fampra/17.6.535
  20. Geense WW, van de Glind IM, Visscher TL, van Achterberg T. Barriers, facilitators and attitudes influencing health promotion activities in general practice: an explorative pilot study. BMC Fam Pract 2013;14:20. https://doi.org/10.1186/1471-2296-14-20
  21. Holmberg C, Sarganas G, Mittring N, Braun V, Dini L, Heintze C, et al. Primary prevention in general practice - views of German general practitioners: a mixed-methods study. BMC Fam Pract 2014;15:103. https://doi.org/10.1186/1471-2296-15-103
  22. Luquis RR, Paz HL. Attitudes about and practices of health promotion and prevention among primary care providers. Health Promot Pract 2015;16(5):745-755. https://doi.org/10.1177/1524839914561516
  23. Rubio-Valera M, Pons-Vigues M, Martinez-Andres M, Moreno-Peral P, Berenguera A, Fernandez A. Barriers and facilitators for the implementation of primary prevention and health promotion activities in primary care: a synthesis through metaethnography. PLoS One 2014;9(2):e89554. https://doi.org/10.1371/journal.pone.0089554
  24. Eisner D, Zoller M, Rosemann T, Huber CA, Badertscher N, Tandjung R. Screening and prevention in Swiss primary care: a systematic review. Int J Gen Med 2011;4:853-870.
  25. Anderson AS, Klemm P. The Internet: friend or foe when providing patient education? Clin J Oncol Nurs 2008;12(1):55-63. https://doi.org/10.1188/08.CJON.55-63
  26. Cline RJ, Haynes KM. Consumer health information seeking on the Internet: the state of the art. Health Educ Res 2001;16(6):671-692. https://doi.org/10.1093/her/16.6.671
  27. Renahy E, Chauvin P. Internet uses for health information seeking: a literature review. Rev Epidemiol Sante Publique 2006;54(3):263-275. https://doi.org/10.1016/S0398-7620(06)76721-9
  28. Collet TH, Salamin S, Zimmerli L, Kerr EA, Clair C, Picard-Kossovsky M, et al. The quality of primary care in a country with universal health care coverage. J Gen Intern Med 2011;26(7):724-730. https://doi.org/10.1007/s11606-011-1674-0
  29. Patel A, Schofield GM, Kolt GS, Keogh JW. General practitioners' views and experiences of counselling for physical activity through the New Zealand Green Prescription program. BMC Fam Pract 2011;12:119. https://doi.org/10.1186/1471-2296-12-119
  30. Selby K, Cornuz J, Senn N. Establishment of a representative practice-based research network (PBRN) for the monitoring of primary care in Switzerland. J Am Board Fam Med 2015;28(5):673-675. https://doi.org/10.3122/jabfm.2015.05.150110
  31. Koch-Weser S, Bradshaw YS, Gualtieri L, Gallagher SS. The Internet as a health information source: findings from the 2007 Health Information National Trends Survey and implications for health communication. J Health Commun 2010;15 Suppl 3:279-293. https://doi.org/10.1080/10810730.2010.522700
  32. McMullan M. Patients using the Internet to obtain health information: how this affects the patient-health professional relationship. Patient Educ Couns 2006;63(1-2):24-28. https://doi.org/10.1016/j.pec.2005.10.006
  33. Jacobs W, Amuta AO, Jeon KC. Health information seeking in the digital age: an analysis of health information seeking behavior among US adults. Cogent Soc Sci 2017;3(1):1302785. https://doi.org/10.1080/23311886.2017.1302785
  34. Grandes G, Sanchez A, Cortada JM, Balague L, Calderon C, Arrazola A, et al. Is integration of healthy lifestyle promotion into primary care feasible? Discussion and consensus sessions between clinicians and researchers. BMC Health Serv Res 2008;8:213. https://doi.org/10.1186/1472-6963-8-213
  35. Johansson H, Stenlund H, Lundstrom L, Weinehall L. Reorientation to more health promotion in health services - a study of barriers and possibilities from the perspective of health professionals. J Multidiscip Healthc 2010;3:213-224. https://doi.org/10.2147/JMDH.S14900

Cited by

  1. Primary prevention of sexually transmitted infections in Switzerland: practices of family physicians and their determinants—a national cross-sectional survey vol.10, pp.9, 2020, https://doi.org/10.1136/bmjopen-2019-032950