Non-consulters and high consulters in general practice: cardio-respiratory health and risk factors
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J K Morris1, D G Cook, M Walker
1Department of Public Health and Primary Care, Royal Free Hospital School of Medicine, London.
Insights
High consulting men show greater ill-health and unhealthy lifestyles, indicating a greater need for health promotion services. Non-consulters and average consulters had similar health profiles.
Area of Science:
- General Practice
- Preventive Medicine
- Cardiology
Background:
- The 1990 General Practitioner contract mandates health promotion and illness prevention for patients aged 16-74.
- Understanding consultation patterns can identify patient groups with higher health needs.
Purpose of the Study:
- To compare cardio-respiratory health and risk factors among men with varying consultation rates.
- To assess the relative need for health promotion and illness prevention services based on consultation frequency.
Main Methods:
- A three-year consultation rate analysis was conducted on 7010 middle-aged men in Great Britain.
- Participants were categorized into non-consulters, average consulters (3-5 consultations), and high consulters (≥24 consultations).
- Health and lifestyle characteristics were compared across these groups.
Main Results:
- High consulters (n=306) exhibited a greater burden of ill-health and less healthy lifestyles compared to non-consulters (n=1025) and average consulters (n=1585).
- Over 50% of high consulters reported chest pain, chronic bronchitis, breathlessness, or wheeze, versus 23-27% in other groups.
- Prevalence of diagnosed high blood pressure increased significantly with consultation frequency (6% non-consulters, 10% average, 29% high consulters).
- Lifestyle risk factors like smoking, heavy drinking, and obesity were more prevalent in high consulters (61%) than non-consulters (48%) and average consulters (47%).
Conclusions:
- Men with high consultation rates represent a group with significant unmet health needs.
- Targeted health promotion and illness prevention strategies are crucial for high-consulting individuals.
- Non-consulters and average consulters share similar health and lifestyle profiles, suggesting different intervention approaches.
Abstract:
The 1990 General Practitioner contract requires that health promotion and illness prevention services should be provided to all patients aged 16-74 years. Consultation rates over a period of three years were examined in 7010 middle-aged men in Great Britain to compare the cardio-respiratory health and risk factor status of non-consulters (men who did not consult in three years) with those of average consulters (men who consulted 3-5 times in three years) and high consulters (men who consulted 24 or more times in three years) to assess their relative need for health promotion and illness prevention services. The non-consulters (n = 1025) were remarkably similar to the average consulters (n = 1585) in health and lifestyle characteristics. The high consulters (n = 306) had a greater burden of ill-health and a less healthy lifestyle. Chest pain on exertion, chronic bronchitis, breathlessness or wheeze were present in 23 per cent of non-consulters, 27 per cent of average consulters and over 50 per cent of high consulters. Similarly, 48 per cent of the non-consulters smoked, drank heavily or were obese compared with 47 per cent of the average consulters and 61 per cent of the high consulters. The prevalence of recall of high blood pressure which had been diagnosed by a doctor rose from 6 per cent in non-consulters and 10 per cent in average consulters to 29 per cent in high consulters.(ABSTRACT TRUNCATED AT 250 WORDS)