Lifestyle discussions during doctor-older patient interactions: the role of time in the medical encounter.

Marcia G Ory, B Mitchell Peck, Colette Browning, Samuel N Forjuoh
Author Information
  1. Marcia G Ory: School of Rural Public Health, Texas A&M Health Science Center, College Station, Texas, USA. mory@srph.tamhsc.edu

Abstract

CONTEXT: Although physician influence can be especially powerful with older adults, relatively little is known about how primary care physicians (PCPs) interact with their patients regarding lifestyle issues.
OBJECTIVE: To document the length of time that PCPs discuss lifestyle issues with their older patients and to examine patient, physician, and contextual correlates.
DESIGN: Descriptive and multivariate analysis of videotapes of physician-patient encounters.
SETTING: Medical encounters from 3 primary care ambulatory settings.
PATIENTS: There were 116 ongoing medical encounters with patients aged 65 years or older.
MAIN OUTCOME MEASURES: Total time spent in physical activity (PA) discussions and total time spent discussing PA, nutrition, and smoking during the medical encounter.
RESULTS: Very little time was spent in lifestyle discussions. On average, PA was discussed for less than a minute (58.28 seconds) and nutrition for slightly less than 90 seconds (83.11 seconds). Only about 10% of the average 17-minute, 22-second encounter was spent on physical activity, nutrition, or smoking topics. Physician supportiveness score (beta = 8.92, P CONCLUSION: There is a critical need for additional training of primary care providers on how to discuss lifestyle issues in the most time-efficient but effective manner to achieve positive behavior change associated with improved health outcomes. There is also a need for the institutionalization of policies to encourage more lifestyle discussions.

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Grants

  1. 5U48DP000045/NCCDPHP CDC HHS
  2. N43-AG-6-2118/NIA NIH HHS
  3. R44AG15737/NIA NIH HHS

MeSH Term

Aged
Ambulatory Care
Attitude of Health Personnel
Female
Geriatric Assessment
Health Behavior
Humans
Life Style
Male
Multivariate Analysis
Needs Assessment
Physician-Patient Relations
Physicians, Family
Primary Health Care
Probability
Quality of Health Care
Time Factors
Video Recording

Word Cloud

Created with Highcharts 10.0.0lifestyletimediscussionsspentolderprimarycarepatientsissuesencountersmedicalPAnutritionencountersecondsphysicianlittlePCPslengthdiscusspatientphysicalactivitysmokingaveragediscussedlesstopicsbeta=P001LifestylealsoneedCONTEXT:AlthoughinfluencecanespeciallypowerfuladultsrelativelyknownphysiciansinteractregardingOBJECTIVE:documentexaminecontextualcorrelatesDESIGN:Descriptivemultivariateanalysisvideotapesphysician-patientSETTING:Medical3ambulatorysettingsPATIENTS:116ongoingaged65yearsMAINOUTCOMEMEASURES:TotaltotaldiscussingRESULTS:minute5828slightly90831110%17-minute22-secondPhysiciansupportivenessscore892number10639significantlycorrelateddiscussionlikelyoccurlongervisitsCONCLUSION:criticaladditionaltrainingproviderstime-efficienteffectivemannerachievepositivebehaviorchangeassociatedimprovedhealthoutcomesinstitutionalizationpoliciesencouragedoctor-olderinteractions:role

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