A novel approach to population-based risk stratification, comprising individualized lifestyle intervention in Danish general practice to prevent chronic diseases: Results from a feasibility study

Health Informatics J. 2017 Dec;23(4):249-259. doi: 10.1177/1460458216645149. Epub 2016 May 31.

Abstract

Early detection of patients at risk seems to be effective for reducing the prevalence of lifestyle-related chronic diseases. We aim to test the feasibility of a novel intervention for early detection of lifestyle-related chronic diseases based on a population-based stratification using a combination of questionnaire and electronic patient record data. The intervention comprises four elements: (1) collection of information on lifestyle risk factors using a short 15-item questionnaire, (2) electronic transfer of questionnaire data to the general practitioners' electronic patient records, (3) identification of patients already diagnosed with a lifestyle-related chronic disease, and (4) risk estimation and stratification of apparently healthy patients using questionnaire and electronic patient record data on validated risk estimation models. We show that it is feasible to implement a novel intervention that identifies and stratifies patients for further examinations in general practice or behaviour change interventions at the municipal level without any additional workload for the general practitioner.

Keywords: electronic health records; health-care service innovation and information technology; information technology design and development methodologies; primary care; targeted prevention.

MeSH terms

  • Adult
  • Chronic Disease / prevention & control
  • Community Health Planning / methods*
  • Feasibility Studies
  • Female
  • General Practice / methods
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Patient-Centered Care / methods
  • Risk Assessment / methods*
  • Risk Factors
  • Risk Reduction Behavior*
  • Surveys and Questionnaires