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Missed opportunities in preventive counseling for cardiovascular disease--United States, 1995
Insights
Physicians provided limited counseling on physical activity, healthy diet, and smoking cessation in 1995. This missed opportunity for cardiovascular disease (CVD) prevention highlights a gap in primary care.
Area of Science:
- Public Health
- Preventive Medicine
- Cardiology
Background:
- Cardiovascular disease (CVD) is the leading cause of death in the U.S., affecting 58 million people.
- Key behavioral risk factors for CVD include physical inactivity, poor diet, overweight, and smoking.
- Preventive guidelines recommend counseling for these behaviors during primary care visits.
Purpose of the Study:
- To assess the extent of physician counseling on preventive health behaviors during office visits in 1995.
- To identify gaps in the delivery of CVD prevention counseling.
Main Methods:
- Analysis of data from the National Ambulatory Medical Care Survey (NAMCS) conducted in 1995.
- Focus on office visits where counseling on physical activity, diet, and smoking cessation could have occurred.
Main Results:
- A significant proportion of office visits in 1995 did not include counseling for CVD prevention.
- Physician counseling on physical activity, healthy diet, and smoking cessation was not consistently provided.
Conclusions:
- The findings indicate a substantial gap in the provision of preventive counseling for cardiovascular disease.
- Primary care physicians may not be adequately addressing critical behavioral risk factors during patient encounters.
- Interventions are needed to improve the integration of CVD prevention counseling into routine primary care.
Abstract:
Cardiovascular disease (CVD), the leading cause of death in the United States, caused 960,592 deaths in 1995 (41.5% of all deaths). Approximately 58 million persons in the United States (20% of the total population) have one or more types of CVD, which include high blood pressure, coronary heart disease, stroke, rheumatic fever or rheumatic heart disease, and other forms of heart disease. Behavioral risk factors for CVD and other chronic diseases include physical inactivity, a diet high in fat, overweight, and smoking. The U.S. Preventive Services Task Force and the American Heart Association recommend that all primary-care providers offer their patients counseling to promote physical activity, a healthy diet, and smoking cessation as part of the preventive health examination. To characterize the provision of counseling by physicians about preventive health behaviors during office visits in 1995, data were analyzed from CDC's National Ambulatory Medical Care Survey (NAMCS). This report summarizes the results of that analysis, which indicates that a high proportion of office visits in 1995 did not include counseling for the prevention of CVD.