Australian GPs are failing in their attempts to help overweight or obese patients lose weight because they are mistaking low health literacy with a lack of motivation, according to new research.
In the first study of its kind in Australia, UNSW researchers examined how general practitioners (GPs) and practice nurses (PNs) managed overweight and obese patients with low health literacy in 20 practices in disadvantaged areas in Sydney and Adelaide.
The results of the study, to be presented on Friday at the Primary Health Care Research Conference in Adelaide, found only a few of the 61 health staff surveyed reported assessing a patient’s health literacy.
One in five Australians have very low health literacy resulting in reduced life expectancy and a poor quality of life. Health literacy means having a good understanding of your own health, the measures you can take to improve it and how the healthcare system can help you.
Professor Mark Harris, Executive Director of UNSW’s Centre for Primary Health Care and Equity, said the finding is important because health professionals often confuse low health literacy with poor motivation.
“Many medical professionals wrongly assume the growing ranks of overweight and obese Australians are not sufficiently motivated to lose weight. Instead, existing research suggests low health literacy may be the culprit,” Professor Harris said.
The UNSW study found while more than half the GPs and PNs surveyed reported regularly assessing diet, physical activity and Body Mass Index (BMI), goal setting and referral to other services were less frequently reported.
Professor Harris said of most concern was that only 15% reported success in treating obese patients and only 26% enjoyed treating obese patients.
“If we are to rein in the growing obesity rates in Australia, the assessment, education and referral of overweight and obese patients must improve,” Professor Harris said.
“Sound National Health and Medical Research Council (NHMRC) obesity management guidelines to assess health literacy in patients are already available and are based on five key steps: ask, assess, advise/agree, assist and arrange.”
“But unless clinicians are routinely using these guidelines the problems remain. That means we must tackle some of barriers that frustrate doctors and practice nurses, particularly time pressures and difficulties dealing patients who seem disengaged.”
Professor Harris and his team are currently assessing how the NHMRC guidelines can be best incorporated into GP practices and what support regional primary care organisations should provide to practices.
“This is especially important for practices in low socioeconomic areas where staff may have greater time pressures,” Professor Harris said.
“In this age when we are drowning in information about lifestyle and weight management, it is important that people with low health literacy are not left behind.”
“Tailoring our approach to the needs of those with low health literacy is part of the solution to reversing this trend.”