title: Increased attendance rate: BMI matters, lifestyles don't. Results from the Dutch SMILE study.
abstract: BACKGROUND
  a small group of frequent attenders is responsible for a disproportional large percentage of all daytime consultations in general practice. High attendance rates are related to demographic and psychological characteristics. Differences in attendance rates are only partly explained by chronic diseases. Furthermore, lifestyles might be relevant too. The aim of this study was to examine the effect of lifestyle on attendance rates.
  
  
  METHODS
  this study is part of the Study of Medical Information and Lifestyles in Eindhoven, the Netherlands (SMILE). Generalized estimated equations were used to determine the relation between attendance rate and the different lifestyle factors (N = 4444).
  
  
  RESULTS
  a higher body mass index was related to increased attendance rate in both male [relative risk (RR) 1.02; 95% confidence interval (CI) 1.01-1.03] and female patients (RR 1.01; 95% CI 1.01-1.02). Lifestyles were not related to the attendance rate, except for a sedentary lifestyle in women (RR 1.08; 95% CI 1.04-1.12).
  
  
  CONCLUSIONS
  since half of the Dutch population suffers from overweight or obesity and this number is still increasing, attendance rates will rise further. In order to relieve the GPs, nurse practitioners could play a more prominent role in lifestyle interventions concerning overweight and obesity and its related diseases.
authors.affiliation: Department of General practice, School for Public Health and Primary Care (CAPHRI), Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: Ben
authors.initials: B
authors.lastname: van Steenkiste
authors.forename: Mieke F
authors.initials: MF
authors.lastname: Knevel
authors.forename: Marjan
authors.initials: M
authors.lastname: van den Akker
authors.forename: Job F M
authors.initials: JF
authors.lastname: Metsemakers
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D015992:Body Mass Index; D002908:Chronic Disease; D004032:Diet; D015444:Exercise; D005260:Female; D005638:Fruit; D058006:General Practice / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009819:Office Visits / Q000706:statistics & numerical data* / Q000639:trends; D011788:Quality of Life; D057185:Sedentary Behavior; D012907:Smoking; D014675:Vegetables; D055815:Young Adult