Improving the health behaviours of elderly people: randomised controlled trial of a general practice education programme

Abstract

Objectives: To establish the effect of an educational intervention for general practitioners on the health behaviours and wellbeing of elderly patients. Design: Randomised controlled trial with 1 year follow up. Setting: Metropolitan general practices in Melbourne, Australia. Subjects: 42 general practitioners and 267 of their patients aged over 65 years. Intervention: Educational and clinical practice audit programme for general practitioners on health promotion for elderly people. Main outcome measures: Patients' physical activity, functional status, self rated health, immunisation status, social contacts, psychological wellbeing, drug usage, and rate of influenza vaccination. Primary efficacy variables were changes in outcome measures over 1 year period. Results: Patients in the intervention group had increased (a) walking by an average of 88 minutes per fortnight, (b) frequency of pleasurable activities, and (c) self rated health compared with the control group. No change was seen in drug usage, rate of influenza vaccination, functional status, or psychological wellbeing as a result of the intervention. Extrapolations of the known effect of these changes in behaviour suggest mortality could be reduced by 22% if activity was sustained for 5 years. Conclusions: Education of the general practitioners had a positive effect on health outcomes of their elderly patients. General practitioners may have considerable public health impact in promotion of health for elderly patients. Few educational interventions for doctors have shown benefit to the health of patients Elderly people were identified in the UK health initiatives as in need of additional attention, and levels of health protective behaviours were low in community surveys A multifaceted educational intervention for general practitioners was effective in improving walking behaviour, self rated health status, and the frequency of social contacts in elderly patients General practitioners are effective in improving health and health behaviours in their elderly patients