title: Is identification of smoking, risky alcohol consumption and overweight and obesity by General Practitioners improving? A comparison over time.
abstract: BACKGROUND
  Detection of lifestyle risk factors by GPs is the first step required for intervention. Despite significant investment in preventive health care in general practice, little is known about whether GP detection of lifestyle risk factors have improved over time.
  
  
  OBJECTIVE
  To examine whether sensitivity and specificity of GP detection of smoking, risky alcohol consumption and overweight and obesity has increased in patients presenting to see their GP, by comparing results from four Australian studies conducted between 1982 and 2011.
  
  
  METHODS
  Demographic characteristics of patient and GP samples and the prevalence, sensitivity and specificity of detection of each risk factor were extracted from published studies. Differences between GP and patient sample characteristics were examined. To identify trends over time in prevalence of risk factors, sensitivity and specificity of detection across studies and the Cochran-Armitage test for trend were calculated for each risk factor for the overall sample and by male and female subgroups.
  
  
  RESULTS
  There were no statistically significant changes in the sensitivity of GP detection of smoking or overweight or obesity over time. Specificity of detection of smoking increased from 64.7% to 98% (P < 0.0001) and decreased for overweight or obesity from 92% to 89% (P = 0.01). There was a small decrease in the sensitivity of detection of alcohol consumption (P = 0.02) and an increase in specificity (P = 0.01).
  
  
  CONCLUSIONS
  Despite significant investment to increase GP detection and intervention for lifestyle risk factors, accurate detection of smoking, risky alcohol consumption and overweight and obesity occurs for less than two-thirds of all patients.
authors.affiliation: Priority Research Centre for Health Behaviour, University of Newcastle, Hunter Medical Research Institute, HMRI Building, University of Newcastle, Callaghan, NSW 2308, Jamie.Bryant@newcastle.edu.au.
authors.forename: Jamie
authors.initials: J
authors.lastname: Bryant
authors.affiliation: Hunter New England Population Health, c/o Booth Building, Wallsend, NSW 2287.
authors.forename: Sze Lin
authors.initials: SL
authors.lastname: Yoong
authors.affiliation: Priority Research Centre for Health Behaviour, University of Newcastle, Hunter Medical Research Institute, HMRI Building, University of Newcastle, Callaghan, NSW 2308.
authors.forename: Rob
authors.initials: R
authors.lastname: Sanson-Fisher
authors.affiliation: Department of General Practice, School of Primary Health Care, Monash University, Building 1, 270 Ferntree Gully Rd, Notting Hill, VIC 3168 and.
authors.forename: Danielle
authors.initials: D
authors.lastname: Mazza
authors.affiliation: Priority Research Centre for Health Behaviour, University of Newcastle, Hunter Medical Research Institute, HMRI Building, University of Newcastle, Callaghan, NSW 2308.
authors.forename: Mariko
authors.initials: M
authors.lastname: Carey
authors.affiliation: Priority Research Centre for Health Behaviour, University of Newcastle, Hunter Medical Research Institute, HMRI Building, University of Newcastle, Callaghan, NSW 2308.
authors.forename: Justin
authors.initials: J
authors.lastname: Walsh
authors.affiliation: Clinical Research Design IT and Statistical Support Unit, Hunter Medical Research Institute, HMRI Building, University of Newcastle, Callaghan, NSW 2308, Australia.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bisquera
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D000437:Alcoholism / Q000175:diagnosis*; D001315:Australia / Q000453:epidemiology; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005260:Female; D058005:General Practitioners; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000175:diagnosis*; D055815:Young Adult
keywords: Alcohol drinking; general practice; obesity; smoking.