RT Journal Article
SR Electronic
T1 Mental health and the relationship between health promotion counseling and health outcomes in chronic conditions
JF Canadian Family Physician
JO Can Fam Physician
FD The College of Family Physicians of Canada
SP e113
OP e120
VO 60
IS 2
A1 Fatima Al Sayah
A1 Calypse Agborsangaya
A1 Markus Lahtinen
A1 Tim Cooke
A1 Jeffrey A. Johnson
YR 2014
UL http://www.cfp.ca/content/60/2/e113.abstract
AB Objective To explore the relationship between health promotion counseling (HPC) provided by FPs and health-related quality of life (HRQL) and the use of health care services among patients with chronic conditions, while assessing the effect of mental health on these relationships. Design Telephone survey using random-digit dialing. Setting Alberta. Participants A total of 1615 participants with chronic conditions. Main outcome measures Health promotion counseling provided by FPs, which was assessed using 4 questions; HRQL using the Euro quality of life 5-dimensions (EQ-5D) questionnaire; and the use of health care services assessed with self-reported emergency department (ED) visits and hospitalizations. Results Of the 1615 participants with chronic conditions, 55% were female and more than two-thirds were older than age 45 years. Less than two-thirds of participants received HPC from their FPs. In patients without anxiety or depression, those who needed help from their FPs in making changes to prevent illness had a 0.05 lower EQ-5D score than those who did not (P < .001); and those who received diet counseling had a 0.03 higher EQ-5D score than their counterparts did (P = .048). However, these associations were not observed in patients with anxiety or depression. Patients were more likely to have visited EDs if they needed their physicians’ help in making changes to prevent illness (odds ratio 1.43, 95% CI 1.08 to 1.89) and less likely to visit EDs if they had been encouraged by their physicians to talk about their health concerns (odds ratio 0.69, 95% CI 0.52 to 0.91). None of the HPC items was associated with hospitalizations. Conclusion Not all patients with chronic conditions are receiving HPC from their FPs. Also, there is an association between HPC and important health outcomes (ie, HRQL and ED visits), but this association is not apparent for those with anxiety or depression.