Prevention in primary healthcare

Their GP practice is usually people’s first port of call when they are experiencing health problems. The causes often lie in an unhealthy lifestyle, or problems of a social nature. We are therefore investing in knowledge for professionals in primary healthcare, to help them develop primary prevention services, or improve their collaboration with public healthcare and social welfare, for example.

Knowledge about prevention in primary healthcare

As a GP or allied health professional, you will be fully aware of how important prevention is, to ensure that people do not become ill. This is in their interests, and it is also vital in order to reduce the burden on the healthcare system.

Lack of time is often a problem, and generally means there is insufficient opportunity to discuss lifestyle and offer advice. Many GPs would like to advise their patients on lifestyle more than they do at present. Other problems include reluctance to act, or not always knowing where to refer people.

ZonMw is identifying what knowledge is needed in terms of prevention in GP practice and the allied health professions. Researchers are developing knowledge about lifestyle for use in disease prevention, and also as ‘medicine’, and they promote the use of this knowledge in practice. Attention also focuses on encouraging collaboration in the local community.

Collaboration between primary healthcare, public healthcare and social welfare

Lifestyle advice would benefit from better connections between primary healthcare, public healthcare and social welfare. Since professionals are more likely to have contact within a community, patients receive better help with their lifestyle, and on issues of a social nature. Researchers are developing knowledge for a successful, coherent and accessible supply of prevention services in local communities.

This focus on collaboration is also reflected in training (available in Dutch). Researchers are developing innovations and ways of collaborating in basic and post-basic training. Healthcare professionals learn during their training to take a broader view, for example. They learn to enter into conversation with their patients about adopting a healthier lifestyle, and to work with professionals in public healthcare and social welfare.

Developing knowledge for prevention services in primary healthcare

Researchers have developed knowledge to enhance the evidence base for and implementation of preventive services in primary healthcare, and to improve interprofessional collaboration.

One good example of this is the factsheet on POH-GGZ (available in Dutch) which offers practical support to GPs concerning mental healthcare.

It shows how this role is organised in daily practice, and what results the service achieves.

Referring overweight patients for combined lifestyle intervention

As a GP, you can refer patients who run health risks as a result of overweight for a combined lifestyle intervention (CLI).  The goal of a CLI is for the patient to achieve a healthy weight which they can maintain. CLI is accessible to all patients, as it is covered by basic health insurance.

Using lifestyle as ‘medicine’

A healthy lifestyle is important to prevent illness, but it can also be used to help people who are already ill. Changes in lifestyle can ensure that patients with some conditions are less burdened by their disease, and can sometimes even cure them. Examples of lifestyle medicine in general practice (available in Dutch) include:

  • Overweight patients with arthritic knees can be referred for a combined lifestyle intervention (CLI)  
  • Diabetes patients with practical training may benefit from a group intervention session on dealing with their disease.
  • Cancer patients who are working on their recovery can benefit from a blended care approach to lifestyle behaviours at their GP practice.
  • People with psychiatric problems benefit from good sleep, which is essential in order to learn new behaviour. Patients can now get help to sleep better before their treatment commences.

Referral and advice method to help people quit smoking

No fewer than 80% of all smokers want to quit, but only a small proportion of them manage to do so without help. The Very Brief Advice Plus method (available in Dutch) allows GPs to issue patients with a warm referral for professional counselling and guidance. Patients do not then need to pursue the referral or make an appointment themselves.

Affordable healthy food for everyone on a low income

Dieticians use this intervention to help people on a low income opt for affordable healthy food (available in Dutch). Researchers are focusing on the implementation of this intervention, to ensure that as many people on a low income as possible are able to benefit from it.