gms | German Medical Science

Background: A healthy life style can prevent many diseases, and improve the health of those already affected by illness. The Swedish Health and Medical Services Act states that those who turn to the healthcare system should, when appropriate, be given information about methods to prevent disease. Still, efforts to prevent disease do not occupy an undisputed place in the healthcare system. There is no uniform clinical practice, methods used are not sufficiently evidence-based and there are large variations among regions.

Objectives: Therefore, the National Board of Health and Welfare has developed guidelines for disease prevention, which include interventions to reduce smoking, hazardous use of alcohol, insufficient physical activity and unhealthy diet.

Methods: The first step was a review of the scientific literature. In a second step, a group of clinicians prioritized the interventions from 1 to 10.The method used is based upon the national model for prioritization (described in a separate abstract). Indicators for national assessment and evaluation were also developed (described in another abstract).

Results: The recommendation for hazardous use of alcohol was counselling, and for insufficient physical activity it was repeated counselling combined with exercise on prescription. For smoking and unhealthy diet, more extensive theory based counselling was recommended.

Implications for guideline users: When implementing the guidelines, health care staff will need training and more time for preventive work. Analysis suggests, however, that in the long run costs will be offset by savings. Work is underway to integrate the indicators into ordinary data records, and to form consensus on use of the guidelines in clinical practice.