BACKGROUND Little is known about whether a more comprehensive health assessment, performed by a general practitioner (GP) during a clinical encounter, could influence patients' lifestyle. We aimed to investigate whether health assessments, performed by GPs, are more important than the presence of cardiovascular disease (CVD) or cardiometabolic risk factors (obesity, diabetes, hypertension, dyslipidaemia) for engagement in lifestyle change. METHODS Cross-sectional, population-based survey conducted in South Australia (September-December 2017) using face-to-face interviews and self-reported data of 2977 individuals aged 15+ years. The main outcome was engagement in four lifestyle changes: 1) increasing fruit/vegetable intake, 2) increasing physical activity level, 3) reducing alcohol consumption, and 4) attempts to stop smoking. Health assessments performed by a GP in the last 12 months included clinical/laboratory investigations (weight/waist circumference, blood pressure, glucose levels, lipid levels) and questions about lifestyle/wellbeing (current diet, physical activity, smoking status, alcohol intake, mental health, sleeping problems). Results were restricted to individuals aged 35+ years because of the low prevalence of CVD or their risk factors among younger participants. Logistic regression was used in all associations, adjusted for sociodemographic, lifestyle, mental health, and clinical variables. RESULTS Of the 2384 investigated adults (mean age 57.3 ± 13.9 years; 51.9% females), 10.2% had CVD and 49.1% at least one cardiometabolic risk factor. Clinical/laboratory assessments performed by the GP were 2-3 times more frequent than assessments of lifestyle, mental health status, or sleeping problems, especially among those with CVD. Individuals with CVD or a cardiometabolic risk factor were no more likely to be increasing their fruit/vegetable consumption (33.6%), physical activity level (40.9%), reducing alcohol consumption (31.1%), or trying to quit smoking (34.0%) than 'healthy' participants. However, lifestyle changes were between 30 and 100% more likely when GPs performed three or more health assessments (either clinical/laboratory or questions about lifestyle/wellbeing) than when individuals did not visit the GP or when GPs performed no any assessment during these clinical encounters (p < 0.05 in all cases). CONCLUSION More frequent and comprehensive CVD-related assessments by GPs were more important in promoting a healthier lifestyle than the presence of CVD or cardiometabolic risk factors by themselves.

中文翻译：

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患者报告的全科医生健康评估而不是个人心血管风险负担与生活方式改变相关：南澳大利亚基于人口的调查。


背景技术 对于全科医生（GP）在临床就诊期间进行的更全面的健康评估是否会影响患者的生活方式，人们知之甚少。我们的目的是调查全科医生进行的健康评估对于参与生活方式的改变是否比心血管疾病 (CVD) 或心脏代谢危险因素（肥胖、糖尿病、高血压、血脂异常）更重要。方法 在南澳大利亚州（2017 年 9 月至 12 月）进行了基于人口的横断面调查，使用了 2977 名 15 岁以上个体的面对面访谈和自我报告数据。主要结果是参与四种生活方式的改变：1）增加水果/蔬菜摄入量，2）增加体力活动水平，3）减少饮酒量，4）尝试戒烟。全科医生在过去 12 个月内进行的健康评估包括临床/实验室调查（体重/腰围、血压、血糖水平、血脂水平）以及有关生活方式/健康的问题（当前饮食、体力活动、吸烟状况、酒精摄入量、心理健康、睡眠问题）。由于年轻参与者中 CVD 或其危险因素的患病率较低，因此结果仅限于 35 岁以上的个体。所有关联均使用逻辑回归，并根据社会人口统计学、生活方式、心理健康和临床变量进行调整。结果 在 2384 名接受调查的成年人中（平均年龄 57.3 ± 13.9 岁；51.9% 为女性），10.2% 的人患有 CVD，49.1% 的人至少有一种心脏代谢危险因素。全科医生进行的临床/实验室评估比生活方式、心理健康状况或睡眠问题的评估频率高 2-3 倍，尤其是对于患有 CVD 的患者。 患有心血管疾病或心脏代谢危险因素的个体不太可能增加水果/蔬菜摄入量（33.6%）、体力活动水平（40.9%）、减少饮酒量（31.1%）或尝试戒烟（34.0%）比“健康”的参与者。然而，当全科医生进行三项或更多健康评估（临床/实验室或有关生活方式/健康的问题）时，生活方式改变的可能性比个人未去看全科医生或全科医生在这些临床期间未进行任何评估时高出 30% 至 100%。遭遇（所有情况下 p < 0.05）。结论 全科医生更频繁、更全面的 CVD 相关评估对于促进更健康的生活方式比 CVD 或心脏代谢危险因素本身的存在更重要。