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25-03-2013 | General practice | Article

Behaviour counselling lacks impact

Abstract

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medwireNews: Training GPs in motivational interviewing techniques is not enough to increase positive behavioural changes in patients, researchers report in the BMJ.

In a study of 1827 patients at 27 practices, just over 40% had made a beneficial behaviour change in terms of alcohol consumption, diet, exercise, or smoking after 3 months regardless of whether their GP or practice nurse had completed practice-based and online training.

However, patients interviewed by staff who had received training were more likely to recall discussing behaviour changes with their clinician, to say that they had intended and made attempts to change, and had a greater perception of having made lasting improvements than patients at control practices.

"The lack of lasting change is likely to arise from patient difficulties with adherence to intended [an] plan, suggesting that a single consultation on its own is insufficient to achieve lasting change for important numbers," say Professor Christopher Butler (Cardiff University, UK) and colleagues.

The researchers therefore suggest that longer-term strategies may improve efficacy. "Additional intervention, such as greater exposure to trained clinicians and structured follow-up or referral of patients, may be required to achieve lasting, measureable changes in behaviour," they say.

In an accompanying editorial, Drs Eileen Kaner and Ruth McGovern, from Newcastle University in the UK, note that only half of the clinicians used their new counselling skills to at least some great extent, indicating that the training may not consistently change clinician behaviour.

They also suggest that the intervention may not be effective unless built in to ongoing, interactive professional development and that it may need to be supplemented with decision aids for use in practice.

medwireNews is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

By medwireNews Reporters