bmj.com -- Press Releases

Releases Saturday 9 September 2000
No 7261 Volume 321

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(1) REGULAR JOGGING LEADS TO LONGER LIFE
EXPECTANCY

(2) STUDY REVEALS BARRIERS TO EFFECTIVE
DOCTOR-PATIENT COMMUNICATION

(3) IMPROVING SEXUAL HEALTH IN THE UNITED
KINGDOM

(4) IS NHSnet THE BEST CHOICE FOR IMPROVING
PATIENT CARE?

(1) REGULAR JOGGING LEADS TO LONGER LIFE
EXPECTANCY

(Mortality in joggers: population based study of 4658 men)
http://bmj.com/cgi/content/full/321/7261/602

Despite recent reports of deaths during jogging, a study in this
week's BMJ shows that the risk of death in persistent
joggers is significantly lower than in non-joggers or even
those new to jogging. A total of 4658 Danish men, aged
20-79 years, attended two examinations over a period of five
years. At the first examination, 217 men reported active
jogging. Of these, 96 were still jogging five years later.
Between the two examinations, 106 men started jogging and
4335 men were non-joggers at both examinations.

The authors found a higher risk of death among non-joggers,
or those who jogged at only one of the two examinations,
compared to persistent joggers. This effect was independent
of factors such as smoking, weight, blood pressure and
cholesterol level, add the authors.

The health benefits of physical activity are well known, but
the optimal intensity, frequency and duration of activity has
yet to be firmly established, say the authors. These findings
support the current view in the medical community that,
although light exercise has some value, moderate and
vigorous activity such as jogging is now considered more
favourable for health, they conclude.

Contact:

Peter Schnohr, Chief Cardiologist, The Copenhagen City
Heart Study, Bispebjerg University Hospital, Denmark
Email: peterschnohr{at}dadlnet.dk

(2) STUDY REVEALS BARRIERS TO EFFECTIVE
DOCTOR-PATIENT COMMUNICATION

(Knowledge and communication difficulties for patients with
chronic heart failure: qualitative study)
http://bmj.com/cgi/content/full/321/7261/605

Patients with chronic heart failure often feel unable to ask
their doctors questions about their illness and believe that
doctors are reluctant to provide them with too much
knowledge, finds new research in this week's BMJ. The
study suggests that more effective communication between
doctors and heart failure patients is urgently needed.

Researchers in London interviewed 27 chronic heart failure
patients aged 38-94 years about the effect heart failure had
on their everyday lives. Most patients lacked a clear
understanding of why they had developed heart failure, what
it was, and what this implied for them. Many felt that their
symptoms were a result of growing older and believed that
nothing could be done. Although some patients were
apparently unaware of their likely prognosis, most patients
saw death as inevitable, but felt that doctors were reluctant to
talk about death or dying. One patient stated: "I think they
like to keep things away from the patient."

Patients also described several barriers to communication
with their doctors, including difficulties in getting to hospital
appointments, confusion, short term memory loss and the
belief that doctors did not want to give patients too much
information about their illness or its treatment.

The general lack of knowledge of chronic heart failure
highlights the importance of patient education and information,
say the authors. Some patients may benefit from more open
communication about death and dying and strategies to help
patients ask questions should be developed, particularly given
that chronic heart failure has a worse prognosis than many
cancers, they conclude.

Contact:

Angela Rogers, Research Associate, Guy's, King's and St
Thomas's Medical School and St Christopher's Hospice,
London
Email: Angela.rogers{at}kcl.ac.uk

(3) IMPROVING SEXUAL HEALTH IN THE UNITED
KINGDOM

(Screening for genital chlamydial infection)
http://bmj.com/cgi/content/full/321/7261/629

Genital chlamydial infection - the most common, curable
sexually transmitted disease in the United Kingdom - remains
largely undetected and, as a result, increasing numbers of
people are at risk of developing severe reproductive
complications. This week's BMJ explores a new screening
programme aimed at improving Britain's sexual health.

Since 1988, chlamydia infection in England has risen by 46%,
with rates of infection currently highest in young sexually
active people (16-19 year old women and 20-24 year old
men). With no obvious symptoms, detection outside specialist
clinics is limited. Yet, left untreated, severe complications,
such as pelvic inflammatory disease, ectopic pregnancy and
infertility, are common.

Evidence from Europe and the United States highlight the
benefits of random screening in reducing the level of infection,
particularly in women. This has led to the introduction of a
screening programme now underway in Portsmouth and the
Wirral. The programme will focus on sexually active young
people and screening - involving a simple urine test - will be
offered during routine visits to general practitioners, family
planning or specialist clinics.

It is hoped that this programme will encourage closer
collaboration between primary care and specialist services
and provide a first step towards a more integrated approach
to managing sexual health issues on a wider scale, conclude
the authors.

Contact (via press office):

Simon Gregor, Communications Unit, Public Health
Laboratory Service Headquarters, London
Email: sgregor{at}phls.org.uk

(4) IS NHSnet THE BEST CHOICE FOR IMPROVING
PATIENT CARE?

(Using the internet to access confidential patient records: a
case study)
http://bmj.com/cgi/content/full/321/7261/612

The introduction of a dedicated NHS-wide network
(NHSnet) to improve patient care is already in progress. Yet
concerns about the security of patient information, connection
and user charges may lead to poor uptake, particularly by
general practice. Chadwick and colleagues believe they have
found a safer and more cost-effective system, using existing
internet technology, which they describe in this week's BMJ.

Using an existing information system based in Salford, the
team have developed a secure internet connection that
provides patient information to general practices or even
patients' homes � exactly where GPs seeing sick patients
need immediate access to this information. Home access
would not be possible using NHSnet, they add. They have
ensured patient confidentiality by using strong encryption and
user authentication � stronger methods than those used within
NHSnet, they warn. Furthermore, the system is integrated
into browsers such as Internet Explorer, providing an
interface that is familiar to most people.

This system is as safe, if not safer than, NHSnet, say the
authors, and could be applied to most, if not all, forms of
chronic disease management. With the use of information
technology to improve patient care a key element of the
government's strategy for the new NHS, clinicians should
realise that NHSnet is not the only solution for providing
better access to patients' information.

Contact:

John New, Consultant Diabetologist, Department of Diabetes
and Endocrinology, Hope Hospital, Salford
Email: john.new{at}virgin.net

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