0
0
Many people who visit a primary-care professional are worried about their health, but don’t know what contributes to their risk of cancer, diabetes, cardiovascular diseases and other noncommunicable diseases (NCDs), which lead to 90% of all deaths in the WHO European Region.
A new WHO manual called “Integrated brief interventions for noncommunicable disease risk factors in primary care”, jointly launched by 2 WHO offices as part of the ongoing BRIEF project, aims to change this.
Patients are not informed about risks of cancer or heart disease
Some studies say that 95% of patients do not get any advice on NCD risks when they visit a clinic or other primary-care facility.
To change this, the BRIEF manual proposes shifting the focus of health-service delivery systems so that conversations about healthier choices and better well-being become an everyday reality in clinics and other primary-care facilities – without much burden for primary-care professionals.
The BRIEF manual was produced by the WHO European Office for the Prevention and Control of Noncommunicable Diseases, and was launched jointly with the WHO European Centre for Primary Health Care in November 2022.
Evidence shows brief interventions are effective
“By introducing the WHO-recommended brief interventions, we can substantially reduce the NCD-related burden. But health-care professionals can’t use this tool in isolation. If we can create the system that makes it easy and natural for them to discuss NCD risks with patients, it can become a real game changer,” said Professor Shlomo Vinker, President of the European Regional Branch of the World Organization of Family Doctors (WONCA Europe).
A recent study demonstrated that recommendations to eat healthier food given in primary-care settings led to an increase in consumption of fruits, vegetables and fibre and to a decrease in consumption of fat. Brief interventions related to other NCD risk factors can also have a positive effect on patients’ health and well-being.
Questions that save lives
One of the proposed BRIEF tools is a questionnaire that helps the health-care professional determine the patient’s NCD risks, and supports making shared decisions on a plan to reduce exposure to risk factors. It includes the following questions.
- How soon after you wake up do you smoke your first cigarette?
- How often do you consume sugary food/drinks a week?
- How often do you have a drink containing alcohol?
- How much time do you usually spend sitting or reclining on a typical day?
These simple questions saved the life of Shayakhmet Kussainov, a 73-year-old writer from Kazakhstan. In 2019 he visited his family doctor, worried about his high blood pressure.
“The doctor asked me a series of questions regarding my way of life and habits. At this time of my life, I was a typical writer – I smoked a lot, drank alcohol rather often and had no exercise. The doctor sent me for tests, and they confirmed a pre-diabetic condition and fatty hepatosis. This is how I found myself in the Disease Management Programme led by Dr Venera Duisebayeva, a family doctor who coordinates the nurses’ team,” Shayakhmet recounts.
Changing habits little by little
As part of the Programme, health workers in Kazakhstan’s clinics teach patients to manage their health condition. It changed Shayakhmet’s life.
“First, I needed to confirm that I would follow the agreed plan. Then I started to change my habits little by little: I quit smoking and drinking and eating white bread, and I started walking at least 10 000 steps per day. They even taught my wife how to cook healthy meals with vegetables.”
After a while, Shayakhmet’s wife joined him in adopting healthier eating habits.
In 2022, after he passed the needed control tests and showed the best result of all the patients in his cohort, Shayakhmet was named Patient of the Year by the team of nurses that followed his progress at the Enbekshikazakh Primary Health Care Centre of Excellence.
“My blood sugar is normal, I don’t have any blood pressure problems, and my liver is in good shape too,” he proudly announces.
Time to start the conversation about healthier choices
The new WHO BRIEF manual shows effective ways to support the work of family doctors, nurses and all other primary-care providers, ensuring a patient-centred approach to introduce and scale up brief interventions in everyday practice.
“The major obstacles health-care providers are facing now are the increased workload leading to a lack of time for proactive counselling and the lack of a supporting environment that empowers them to start these conversations with patients,” explains Dr Thomas Frese, Head of Department at the Institute of General Practice at the Medical Faculty of Martin Luther University Halle-Wittenberg in Germany.
Dr Frese adds, “But if the idea of effective brief interventions will be endorsed by policy-makers, health authorities and society, we can create a better system that will make communities healthier all over our Region.”
The BRIEF manual offers an opportunity for any health system to become an important source of health measurement and advice that will improve health and well-being in all countries of the WHO European Region, in line with the WHO European Programme of Work 2020–2025.
Download Here
