0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Current Clinical Issues |

Patient Counseling and Education: Should Doctors Be Doing More?

Jennifer Fisher Wilson
[+] Article and Author Information

Potential Financial Conflicts of Interest: None disclosed.


Ann Intern Med. 2006;144(8):621-624. doi:10.7326/0003-4819-144-8-200604180-00021
Text Size: A A A

Only 3% of U.S. citizens adhere to the 4 key healthy lifestyle characteristics—not smoking, maintaining healthy weight, eating adequate amounts of fruits and vegetables, and exercising regularly—according to a recent telephone survey of 153 000 adults published in the Archives of Internal Medicine. Almost 10% of the respondents adhered to none of the 4 characteristics. The ramifications of such poor health behaviors are much more important than most people realize. Smoking, poor eating habits, and inactivity contribute to more than one third of deaths in the United States, according to the U.S. Centers for Disease Control and Prevention.

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Patient Counseling for the developing world
Posted on May 13, 2006
Hassan Khan
Aga Khan University Hospital
Conflict of Interest: None Declared

The role of patient counseling in decreasing the double burden of both communicable and non communicable diseases in the developing countries cannot be over emphasized. The fact that developing countries constitute 90% of the world's preventable mortality and receive only 10 % of the global health research funding, necessitates the need for an effective intervention 1.

Infectious diseases are one of the leading causes of childhood mortality in developing nations. More than 1.9 million children have died from ARI (acute respiratory infections) in 2000, 70% of them in Africa and Southeast Asia 2. The poor health seeking behavior is one of the major reasons for childhood mortality due to infectious diseases in the developing countries. A recent study done in Rajastan, India showed that training health care workers in counseling improved the appreciation of health care seeking in mothers in the intervention group 3. The WHO estimates that seeking prompt and appropriate care could reduce child deaths due to acute respiratory infections by 20% 3. Thus patient counseling has an important role in improving the patient's knowledge of diseases and their health care seeking behavior.

The article highlights on the importance of individual counseling as a means to improve health and lower the health care expenditure in U.S. 4. In view of the limited resources, patient overload, and disorganized health structure, individual patient counseling is difficult to implement in developing countries. Instead the doctors can play a greater role by educating the society as whole in improving the overall life style behavior. This goal can be achieved via public health care seminars, dissemination of literature in local print media and primary health classes for school children.

The idea of making money through writing green prescription is a good incentive to promote counseling 4. However it might not get popular amongst patients due the high levels of commitment and compliance needed for implementing lifestyle modification. The poor patient health seeking behavior is likely to get worse when no rapid health benefits are seen with life style changes. Only patient health education will improve both compliance and acceptability of such behavioral modifications.

In the wake of the globalization of unhealthy practices the non communicable disease will soon form the major cause of morbidity in developing nations. Already 1.2 billion smokers, 80% of them reside in the developing world 5. Thus patient counseling for improving lifestyle and health seeking behavior may be the only gun for doctors to shoot with.

References

(1) Global Forum for Health Research. The 10/90 report on health research 2003-2004. Geneva: Global Forum for health research 2004

(2) Williams BG, Gouws E, Boschi-Pinto C, Bryce J, Dye C. Estimates of world-wide distribution of child deaths from acute respiratory infections. Lancet Infect Dis. 2002;2:25-32.

(3) Mohan P, Iyengar SD, Martines J, Cousens S, Sen K. Impact of counseling on careseeking behaviour in families with sick children: cluster randomised trial in rural India. BMJ 2004;329:266-9

(4) Wilson JF. Patient counseling and education: should doctors be doing more.Ann Intern Med. 2006;8:621-4.

(5) Boutayeb A, Boutayeb S.The burden of non communicable diseases in developing countries. Int J Equity Health. 2005;4:2.

Conflict of Interest:

None declared

Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)