Eating habits’ assessment in primary health care: a clinical practice support tool

Abstract

Introduction: The prevalence of overweight and obesity has increased in recent decades, reaching about 60% of the Portuguese population. These pathologies are associated with higher morbidity and mortality, translating into an increase in health care expenditure. Primary Health Care (PHC) is responsible for intervening preventively in the population and promoting healthy lifestyles.

Objective: Create a computer clinical practice support tool that allows the family doctor (FD) to address, in an interactive and personalized way, overweight and obesity in adults.

Methods: This tool, designed to integrate the SClínico® layout, would be identified by a button referring to nutrition. Clicking on it would open a questionnaire divided into two parts. Initially, the individual's daily energy needs would be calculated (in kcal), according to the Harris-Benedict Method. Then, an estimation of the daily caloric intake would be obtained using a 24-hour food diary report. The conversion into kcal would be done automatically, using a national database. After filling out the questionnaire, the difference between the individual's caloric needs and the dietary intake would be presented as a daily balance in kcal. This value could be presented to the patient as a starting point for a brief intervention by the FD, dialogue on food errors, and reflection on the consumption/energy expenditure duality. The tool would also allow the consultation of the history of previous records and the printing of health education leaflets. As the main obstacle to its implementation, the authors highlight the limited consultation time.

Discussion and Conclusion: Anticipatory measures and preventive care are priorities in PHC. The proposed tool would amplify the available data for the performance of a brief intervention on patients’ eating habits by the FD, thus promoting and improving this approach in PHC, in line with the national objectives.