Primary care obesity management in Hungary: evaluation of the knowledge, practice and attitudes of family physicians

BACKGROUND: Obesity, a threatening pandemic, has an important public health implication. Before proper medication is available, primary care providers will have a distinguished role in prevention and management. Their performance may be influenced by many factors but their personal motivation is still an under-researched area. METHOD: The knowledge, attitudes and practice were reviewed in this questionnaire study involving a representative sample of 10% of all Hungarian family physicians. In different settings, 521 practitioners (448 GPs and 73 residents/vocational trainees) were questioned using a validated questionnaire. RESULTS: The knowledge about multimorbidity, a main consequence of obesity, was balanced.Only 51% of the GPs were aware of the diagnostic threshold for obesity; awareness being higher in cities (60%) and the highest among residents (90%). They also considered obesity an illness rather than an aesthetic issue.There were wider differences regarding attitudes and practice, influenced by the the doctors' age, gender, known BMI, previous qualification, less by working location.GPs with qualification in family medicine alone considered obesity management as higher professional satisfaction, compared to physicians who had previously other board qualification (77%vs68%). They measured their patients' waist circumference and waist/hip ratio (72%vs62%) more frequently, provided the obese with dietary advice more often, while this service was less frequent among capital-based doctors who accepted the self-reported body weight dates by patients more frequently / commonly. Similar reduced activity and weight-measurement in outdoor clothing were more typical among older doctors.Diagnosis based on BMI alone was the highest in cities (85%). Consultations were significantly shorter in practices with a higher number of enrolled patients and were longer by female providers who consulted longer with patients about the suspected causes of developing obesity (65%vs44%) and offered dietary records for patients significantly more frequently (65%vs52%). Most of the younger doctors agreed that obesity management was a primary care issue.Doctors in the normal BMI range were unanimous that they should be a model for their patients (94%vs81%). CONCLUSION: More education of primary care physicians, available practical guidelines and higher community involvement are needed to improve the obesity management in Hungary

The effect of eating habits on cardiovascular risk factors and the assessed cardiovascular risk

Study was aimed to assess the effect of eating habits on cardiovascular risk factors and the assumed cardiovascular risk among 18–60 years old individuals in Hungary. The 1320 patients were recruited who had not been treated previously because of known cardiovascular risk factors or diseases. Taking questionnaire on eating habits, physical examination, laboratory tests (total cholesterol, LDL-, HDL-cholesterol, triglyceride, fasting blood glucose, OGTT) and cardiovascular risk assessment were carried out.Proportion of involved people who tended to follow healthy diet (determined on the basis of relevant European cardiovascular primary prevention guideline, focusing on the following parameters: total daily calorie-, fat-, cholesterol intake, fruit/vegetable- and salt consumption) was 66%. In “healthy diet” group we found more patients with normal total cholesterol, LDL-cholesterol and triglyceride, blood pressure (BP) and body mass index (BMI) levels compared to “unhealthy diet” group and this difference was significant. There was no significant difference between the quality of diet and HDL-cholesterol and glucose levels. The level of cardiovascular risk changed in line with the quality of diet significantly: among those people who tended to follow a healthy diet, the proportion of low risk individuals was higher whereas among those people who did not care the quality of food, this proportion was the opposite.Intention to follow healthy diet is an important part of cardiovascular risk mitigation policy among adult Hungarian people