Primary Care and Prevention Susanne Reventlow Roar Maagaard Barbara Starfield Workshop 1. Thursday 14th May 2009,

Content of the workshop Part 1: Discussion related to the key-note lecture "General practice as an integrated part of the health care system" by Barbara Starfield Part 2: Conceptualization and discussion of prevention in general practice.

General practice as an integrated part of the health care system Take 5 minutes to discuss with your neighbour thoughts and questions related to the key-note lecture

Prevention in General Practice, questions: What prevention is now provided in General practice in the Nordic countries? What preventive services should be provided by primary care? Similarities and differences between the countries?

Prevention in General Practice, questions: Patient/population orientated activity – disease-prevention activity? Should prevention be disease- orientated? Is disease-monitoring prevention?

General practice Discovery of non-recognized disease or risk factors Case finding Screening (Invisible risk factors) Lifestyle: Motivational interviewing Smoking Alcohol (Visible risk factors) Resources Empowerment Health promotion Investigative work in the local community Collaboration with the municipality Politics Principal functions of municipality physicians Preventive examination of children and pregnant women Prevention in General Practice

System level and ethical issues: Primary care and prevention: Primary care and prevention The risk-drinking project – an effective approach to achieve changes in your patients’ habits of drinking alcohol Risk, screening and decision making:Uncertainty in medical decision making “Couldn’t you have done just as well without the screening?” (Qualitative study of benefits from a health screening) Ethics in prevention:Does the health care system induce harm Health care and other threats against subjective health Prevention of specific diseases and conditions Overweight:To fight the overweight epidemic. Body size perception among obese women Cardiovascular disease, blood pressure:Current European guidelines for management of arterial hypertension Increasing incidence of statin prescribing The European Heart SCORE system – a useful tool in practice? GPs’ decisions on statin therapies by number needed to treat (NNT) Other: Pain as predictor for osteoarthritis in hand, hip and knee. A 10-year prospective population study Motivational interviewing and lifestyle intervention Motivational interviewing – intervention for lifestyle changes Strengthening the patients’ power to implement life style changes Self-reported cognitive and emotional effects and life style changes shortly after preventive cardiovascular consultations in general practice Preventive medicine at the congress

Preventive medicine at the congress: Symposium: S04 Does the health care system induce harm? S14 How can we contribute to fight the overweight epidemic in general practice? Workshops: W1 Primary care and prevention W19 A framework of uncertainty in medical decision making W04 Motivational interviewing – a promising intervention for lifestyle changes in general practice Oral Presentations: OP10.1 Current European guidelines for management of arterial hypertension: are they adequate for use in primary care? OP10.2 Increasing incidence of statin prescribing for the elderly without previous cardiovascular conditions. A nation wide register study OP10.3 The European Heart SCORE system – a useful tool in practice? OP10.4 GPs’ decisions on statin therapies by number needed to treat (NNT) OP05.1 The risk-drinking project – an effective approach to achieve changes in your patients’ habits of drinking alcohol OP05.2 When state-of-the-art medical technologies for prevention of life style related harm meets everyday general OP05.3 Strengthening the patients’ power to implement life style changes OP05.4 Self-reported cognitive and emotional effects and life style changes shortly after preventive cardiovascular consultations in general practice OP08.1 Health care and other threats against subjective health OP08.2 “Couldn’t you have done just as well without the screening?” Qualitative study of benefits from a health screening OP08.3 Body size perception among Inuit women in Greenland: do obese women consider themselves obese? OP08.4 Pain as predictor for osteoarthritis in hand, hip and knee. A 10-year prospective population study