Björknässtudien: Färre läkarbesök i primärvården

Ett livsstilsförändrande program för bättre kost och ökad fysisk aktivitet, genomfört med enkla medel inom primärvården, minskade inte bara en rad riskfaktorer utan även vårdutnyttjandet. Andelen besök hos primärvårdsläkaren var under de tre första åren 21 procent lägre än i kontrollgruppen. Det är intressant med fortsatta undersökningar av livsstilsinterventioners effekt på vårdutnyttjande, dess hälsoekonomiska konsekvenser och effektens underliggande mekanism. Intensive lifestyle interventions can reduce incidence of type 2 diabetes and cardiovascular risk factors in high-risk individuals. We aimed to assess the effect of the lifestyle intervention used in the The Swedish Björknäs study, previously shown to reduce cardiovascular risk factors, on health care use. In 2003, 145 high-risk individuals were randomly assigned to either a 3 months intensive lifestyle modification undertaken in the primary care setting or control. In 2009, participants' medical records were reviewed. Primary outcome was primary care health use. Secondary outcome was hospital care use. Analysis was by intention to treat. Primary care physician visits were 21% (95% CI 2%; 36%) lower in the lifestyle group during the first three years. The difference was significant for all six years when adjusting for baseline (GLM Repeated Measures; p=0.019). There were no significant differences in visits to nurses in primary health care or hospital physicians and nurses, hospitalizations or hospital days. A program of intensive lifestyle modification can not only favourably influence cardiovascular risk factors but also reduce health care use in high-risk individuals.