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Tailoring lifestyle advice as per patient experience design

16821469876_8d062d433d_zLots of people stop smoking every time the tax on cigarettes is raised. It has been said that:

‘A 10% increase in the price of cigarettes in developed countries will result in a 3 to 5% reduction in overall cigarette consumption.’

And in one study only 6% of people were confirmed as non-smokers one year after receiving advice in general practice.

So if we can dissuade enough people from compromising their health with financial disincentives what is the role of the doctor and primary care? What can a health professional do to help when a smoker with a nasty cough seeks advice, and or treatment? It could be argued that the person is aware that their habit has a bearing on the symptoms. Or that by drawing attention to the link with cigarette smoking that the doctor is heightening a sense of shame, self-loathing and guilt.

So what is the role of general practice or primary care in tackling the big issues —smoking, obesity and alcohol abuse? Are brief interventions delivered in this setting more harmful than necessary? What if innovations delivered by practitioners were even more effective than the modest 6% recorded in the past?

An innovation that I was involved in evaluating led to one in seven smokers quitting. An innovation we subsequently developed as an adjunct to the treatment of obesity may well be more effective than diet and exercise regimens used alone. However if these innovations are delivered in a primary care setting then there is a risk that some patients who access them might feel challenged by the having it drawn to their attention that their results are a reflection of their own efforts. Those who fail to achieve the desired results may become disheartened.

It takes an effort to give up a harmful habit and it is now possible to predict and demonstrate the results of our lifestyle choices in ways that appear to matter to us the most. The key for innovators in the’ patient experience design’ space is to ensure that we minimise the harm that could be done by ensuring that such innovations do what they say on the tin and that they are designed with safeguards. What is beyond dispute is that the prevalence of obesity is increasing at an unprecedented rate and every health care professional has a role in combating this issue, not just those with a public health perspective. Some people respond best to health messages that are tailored to their personal circumstances, and as healthcare practitioners, we have a duty to make those options available to them. If you are interested in staying abreast of innovations developed along these lines click here.

Picture by GotCedit


  1. JOanne ritter says:

    Your article is thought-provoking. Separating what is a chemical addiction or a biological propensity from a lifestyle choice is key to communicating a patient’s role. Recently, my own doctor told me my cholesterol levels were too high and continuing to climb. I wanted to start with changing my behaviors to see if that would have an effect, and was really disciplined about it. It didn’t make much difference, and my doctor suggested a genetic link. His manner was to be proactive in addressing any questions, thoughts, or feelings I might have. I felt he was working with me to solve a problem. He explained how and why the drugs work, as well as the risks of side effects. He monitored closely. I felt he listened to me and saw me as a partner in the process, which, of course, I am.

  2. That’s a lovely story – your doctor sounds like a keeper. It’s exactly how we want our medicine men to behave. To work with us from our perspective. That’s what lean medicine hopes to achieve- support those doctors to make the health promotion message part of the patient’s story. To ‘sell’ those messages every bit as effectively as Kellogg’s sells cornflakes. Thanks for the comment Joanne.

  3. The process to leave a bad habit is very tough as craving takes over after initial days of abstinence,it takes a lot of effort and discipline on part of patient and loads of patience in a doctor.

  4. The average “diet and exercise” recommendations handed out are probably way off the mark and likely to produce a much worse result than your experience with the quitting smoking program. I spent a couple of hours yesterday listening to Jonathan Bailor on this subject and his SANE program. His approach fits very well with the work of Bruce Ames on his CHORI-bar experiments. JB says eat more quality foods rather than supplement, but both are saying to lose weight improve your metabolism with more nutrients.
    The best safeguard is a caring doctor who learns not to nag. I leave that to my practice nurse. No program will achieve uniform acceptance and adherence. I asked one grossly obese couple to bring in a few supermarket dockets to show me what they buy, and haven’t mentioned it again despite it not happening. If people chose to take umbrage that is their decision and there are lots of other doctors around.

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