Patients' need for more counseling on diet, exercise, and smoking cessation: results from the National Ambulatory Medical Care Survey.
OBJECTIVE
To determine the percentage of physicians who reported counseling patients on diet/nutrition, exercise, weight reduction, or smoking cessation during their office visits when responding to the 2002 National Ambulatory Medical Care Survey (NAMCS). We sought to establish whether patients are receiving adequate counseling from physicians on the basis of this nationwide survey.


METHODS
Retrospective database analysis.


METHODS
United States.


METHODS
Data included 184,668,007 physician visits for patients diagnosed with type 2 diabetes, hyperlipidemia, hypertension, or obesity; 140,362,102 physician visits for patients in which insulin/oral antidiabetics, antihyperlipidemia drugs, angiotensin-converting enzyme inhibitors, thiazide diuretics, or weight loss drugs were prescribed; and 82,317,640 physician visits for patients who smoked or used tobacco.


METHODS
Not applicable.


METHODS
Frequency of responses for counseling/education/therapy about diet/nutrition, exercise, weight reduction, and tobacco use/exposure.


RESULTS
For patients with type 2 diabetes, hyperlipidemia, or hypertension, or patients receiving a drug in one of the drug classes that may indicate the presence of these diseases, patients did not receive any type of diet or exercise counseling during more than one half of all visits. Visits by patients who were diagnosed as obese were most likely to receive any type of counseling (80.2%). Of visits for patients who used tobacco, 78.6% did not include any counseling about smoking cessation.


CONCLUSIONS
Patients are insufficiently counseled and educated about the need for lifestyle changes that can affect their risks for common chronic diseases. As accessible and ideally positioned health care providers, pharmacists could potentially affect the rising epidemic of obesity and other lifestyle-related diseases by filling this void.
Heaton
Pamela C
PC
College of Pharmacy, University of Cincinnati, Cincinnati, OH 45267-0004, USA. Pam.Heaton@uc.edu
Frede
Stacey M
SM
D003376:Counseling; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy; D004032:Diet; D015444:Exercise; D006801:Humans; D006949:Hyperlipidemias / Q000628:therapy; D006973:Hypertension / Q000628:therapy; D009765:Obesity / Q000628:therapy; D010353:Patient Education as Topic; D010595:Pharmacists; D010820:Physicians; D010818:Practice Patterns, Physicians'; D024382:Professional Role; D012189:Retrospective Studies; D016540:Smoking Cessation