Post by Willow on Jul 9, 2014 15:22:55 GMT 9.5
Posted Tue, 08/07/2014 - 15:51 by Josh Gliddon
Ministry of Health New Zealand, green prescriptions, Australasia, Indigenous Health, General Practice, Complementary, Community Care, Allied Health
When a patient visits a doctor in New Zealand, they often leave with two prescriptions – not one. Should they need medication, they’re given the usual prescription, but if their practitioner thinks lifestyle changes are in order, they’re also issued with a second script, dubbed a Green Prescription.
Like much of the developed world, New Zealand has a problem with fat. The most recent figures from the New Zealand Ministry of Health point to 29 per cent of the population being obese as of 2011, a significant rise from the 19 per cent of adults who were obese in 1997.
The Maori population in particular struggles with obesity, with indigenous levels being close to double that of the white New Zealand population. Pacific Islander populations were even worse off, with obesity levels being triple that of the white population.
The Green Prescription scheme began seven years ago as part of a program initially started by Sport and Recreation New Zealand, notes Sports Auckland manager Jacinta Harris, and was rolled out nationwide in 1998. According to Harris, the program was subsequently transferred to the New Zealand Ministry of Health on 2009. The Green Prescription program is aimed at reducing obesity and the associated chronic diseases, such as COPD and diabetes, which go along with being significantly overweight.
“The program has evolved over time,” Harris says, “and is delivered in a range of different ways throughout the country. It involves many different organisations across New Zealand including Community Recreation Facilities, NGOs and Regional Sports Trusts,” she adds.
How it works
When a patient visits a doctor or practice nurse, if their condition is judged as being stable, and if they are receptive, they’re issued with a Green Prescription (GRx), which is subsequently forwarded to the nearest GRx support person.
The support person encourages the patient to become more active via three to four months of phone calls, along with face to face meetings for the same period of time. There is also six months of group support available to patients.
The patient’s progress is reported back to their referring health professional, and if it’s judged necessary, a subsequent GRx is issued, with the same levels of support.
According to the Ministry of Health New Zealand, all GRx providers have their own databases of people taking part in the program. A spokesperson told eHealthspace.org the patient databases collect information such as demographics, medical conditions, physical activity, along with patient goals and measurements such as BMI, blood pressure and cholesterol levels.
The GRx program is also integrated into a range of practice management systems, including MedTech and Houston, which include the referral form in their systems. The Health New Zealand spokesperson said this makes it quick and easy for the health professional to make a referral.
“Some practices have links from their dashboards so that when a cardiovascular risk assessment is done and the patient is assessed as being inactive, and safe to exercise, the referral can be made,” the spokesperson said.
The results
A survey of GRx patients conducted in 2013 found almost half had lost a significant amount of weight, while 65 per cent had made major changes to their diet, including smaller portion sizes.
“In regards to clinical outcomes the only measure we take is weight and we certainly see a decrease in this,” said Jacinta Harris. “However, we do hear from patients of many other positive changes to their health including improvements in mood, decrease in pain, increase mobility, increase energy, and fitness.”
Studies of the program, including one in the British Medical Journal, also found GRx programs were cost effective in terms of their aims and the subsequent results for patients, in particular when direct supervision or instruction was not required. The same study also found for every ten GRx written, one person achieved and sustained 150 minutes of moderate or vigorous activity per week. This was associated with a 20 to 30 per cent reduction in risk for all-causes mortality compared with sedentary individuals.
Sound slike a great initiative to me