Communicating Cardiovascular Disease Risk to People with Psoriasis: What Techniques do Practitioners Use?
BACKGROUND
Psoriasis can be associated with unhealthy lifestyle behaviours such as smoking, excess alcohol use and insufficient physical activity, consequently increasing cardiovascular disease (CVD) risk. Health care practitioners are expected to discuss lifestyle risk factors with patients with a view to reducing health-related risk for patients. However, little is known about the techniques used to communicate information about risk to patients with psoriasis.


OBJECTIVE
We aimed to examine how primary care practitioners communicate risk information when conducting CVD risk assessments.


METHODS
Consultations (n = 44) between primary care practitioners (general practitioners and practice nurses) and patients with psoriasis across 10 practices were audio-recorded and analysed using content analysis. A coding frame was used to record specific techniques used by practitioners to communicate risk information.


RESULTS
Most frequently used communication methods were verbal descriptors of risk factors accompanied by numerical data (n = 28) rather than verbal descriptors alone (n = 16). Practitioners did not use numerical risk communication methods alone. Where CVD risk factors were discussed with patients (n = 156 occasions across all consultations), interpretations of this information was provided to patients on 131 (84 %) occasions. However, specific advice about behaviour/risk modification was only given on 60 (38.5 %) out of a possible 156 occasions.


CONCLUSIONS
Specific advice about how to change lifestyle behaviour to modify CVD risk factors was not always given by the practitioner, particularly when discussing behavioural risk factors. Developing a best practice for communicating complex health risk information would ensure that people with psoriasis are empowered to make lifestyle modifications to reduce CVD risk.
Manchester Centre for Health Psychology, Institute of Inflammation and Repair, University of Manchester and Manchester Academic Health Science Centre, Stopford Building, Oxford Road, M13 9PT, UK. chris.keyworth@manchester.ac.uk.
Chris
http://orcid.org/0000-0002-7815-6174
C
Keyworth
Manchester Centre for Dermatology Research, Institute of Inflammation and Repair, University of Manchester and Manchester Academic Health Science Centre, Stopford Building, Oxford Road, M13 9PT, UK. pauline.nelson@manchester.ac.uk.
Pauline A
PA
Nelson
West Midlands Collaboration for Leadership in Applied Health Research and Care and Research Institute, Primary Care and Health Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK. c.a.chew-graham@keele.ac.uk.
Carolyn A
CA
Chew-Graham
Manchester Centre for Dermatology Research, Institute of Inflammation and Repair, University of Manchester and Manchester Academic Health Science Centre, Stopford Building, Oxford Road, M13 9PT, UK. Karen.kane@manchester.ac.uk.
Karen
K
Kane
Manchester Centre for Dermatology Research, Institute of Inflammation and Repair, University of Manchester and Manchester Academic Health Science Centre, Stopford Building, Oxford Road, M13 9PT, UK. Christina.pearce@manchester.ac.uk.
Christina J
CJ
Pearce
Manchester Centre for Dermatology Research, Institute of Inflammation and Repair, University of Manchester and Manchester Academic Health Science Centre, Stopford Building, Oxford Road, M13 9PT, UK. Christopher.griffiths@manchester.ac.uk.|Salford Royal NHS Foundation Trust, Barnes Building, Salford, M6 8HD, UK. Christopher.griffiths@manchester.ac.uk.
Christopher E M
CE
Griffiths
Manchester Centre for Health Psychology, Institute of Inflammation and Repair, University of Manchester and Manchester Academic Health Science Centre, Stopford Building, Oxford Road, M13 9PT, UK. anna.chisholm@manchester.ac.uk.
Anna
A
Chisholm
Institute of Inflammation and Repair and Manchester Centre for Health Psychology, University of Manchester and Manchester Academic Health Science Centre Stopford Building, Oxford Road, M13 9PT, UK. lis.cordingley@manchester.ac.uk.
Lis
L
Cordingley
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000209:etiology*; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012907:Smoking / Q000009:adverse effects; D055815:Young Adult
Cardiovascular disease risk; Doctor-patient communication; Prevention; Primary care; Risk communication