Dr Loai Albarqouni is an Assistant Professor at the Bond University Institute for Evidence-Based Healthcare and an NHMRC Emerging Leader Fellow.
We have long known the benefits of lifestyle changes when it comes to preventing and treating one of the nation’s biggest killers – heart disease. But getting patients to understand the impacts of small tweaks to their daily live brings its own challenges.
Research has shown that something as simple as changing the type of salt a patient uses on their food can have similar impact on reducing blood pressure levels as popping a pill. What was once a lifetime sentence of daily medication becomes a simple switch at the supermarket.
Our research found that swapping the usual sodium chloride salt to potassium chloride salt can reduce deaths from heart diseases by 20-25 per cent over three years - just as effective as prescribing blood pressure medication.
Yet the instinct to reach for a pill packet remains.
That’s because for a GP to recommend a lifestyle switch, they need to know a) that it works and b) that it’s accessible to their patients and can be easily prescribed for them.
We’re now exploring practical ways to help GPs offer more non-drug interventions, and to get patients to take them more seriously.
The Heart Foundation’s support of this work means that GPs will have a full toolkit at their fingertips to help them take a lifestyle-first approach to preventing and treating heart disease.
At Bond University’s Institute for Evidence Based Health Care our research has found the barriers preventing GPs and patients from accessing the full range of non-drug interventions include lack of knowledge about their effectiveness, and lack of easy access to information at the point of care.
In collaboration with the Royal Australian College of General Practitioners, Bond’s Institute for Evidence Based Healthcare established the HAndbook of NonDrug Interventions (HANDI) to provide access to evidence-based information about effective non-drug interventions. But the use of non-drug interventions in primary care can be improved.
We also know that patients can react differently to prescriptions for medication than to advice about making lifestyle changes. Issuing a script appears to be more highly valued by patients than generalised health advice. That’s why one of the tools we are examining for our kit is giving GPs the ability to write prescriptions for non-drug interventions.
We hope that receiving a script from a doctor prescribing regular walks, for example, or a change of diet, might improve the likelihood of patient uptake.
Known as ‘social prescribing’ the idea is becoming more common and has been embraced by Britain’s NHS, along with many primary care physicians.
But as my Bond colleagues have noted in previous research on this topic, training is vital to ensure GPs are prescribing effective interventions – just like they wouldn’t write a script for a drug without saying which one, a script for exercise, for example, needs to be specific and tailored to a particular condition.
Our web-based tool will provide all the evidence and support for non-drug interventions in one place, along with localised information about availability of certain products and treatments, as we know that this is a key barrier for GPs when it comes to non-drug interventions.
Another barrier is time. General Practitioners are experiencing growing workloads and an increase in the complexity of cases, so any new tool has to be fully integrated with current systems. The last thing we want is to be adding yet another layer of complexity, we want GPs to have the information they need at their fingertips.
Co-design with GPs and patients is the key to achieving this, and that’s what the heart Foundation grant is supporting us to do. It will allow us to pilot and test the tool with GPs and their patients to be ready for a large-scale evaluation and implementation project.
It’s critical to get this right, so we will be rolling out the pilot with general practitioners who, with their patients, will help refine the tool as we go.
We hope that in time, with the right structures and supports, more and more GPs will flip their own script when it comes to non-drug interventions.