Primary Health Care Research & Development


Using the opinions of coronary heart disease patients in designing a health education booklet for use in general practice consultations

Claire S. Leathema1 c1, Margaret E. Cupplesa1, Mary C. Byrnea2, Molly Byrnea3, Mairead Corrigana4, Susan M. Smitha5 and Andrew W. Murphya2

a1 Department of General Practice and Primary Care, Queen’s University, Belfast, UK

a2 Department of General Practice, National University of Ireland Galway, Galway, Eire

a3 School of Psychology, National University of Ireland Galway, Galway, Eire

a4 Medical Education, Queen’s University, Belfast, UK

a5 Public Health and Primary Care, Trinity College, Dublin, Eire


Aim This study aimed to explore how the views of patients with coronary heart disease (CHD) could inform the design of an information booklet aimed at providing patients and practitioners with a resource to help influence positive health behavioural outcomes.

Background Coronary heart disease has major consequences in terms of patient suffering and economic costs, with morbidity and mortality figures in the United Kingdom and the Republic of Ireland among the highest in Europe. Lifestyle behaviours such as smoking, eating an unhealthy diet and a lack of exercise are strongly associated with an increased CHD risk, and practitioners report that health education materials are used in practice to help advise and educate patients about the consequences of their lifestyle.

Methods Opinions of patients with CHD were explored concerning their information needs, particularly lifestyle advice, using a qualitative approach in four general practices. This information was used to design a booklet for a pilot study aimed at promoting healthy lifestyle behaviours and medication adherence among people with CHD. Focus group discussions explored patients’ opinions about the booklet’s ‘fitness for purpose’; semi-structured interviews with practitioners examined their views on the booklet’s usefulness.

Findings In initial focus groups, patients identified gaps in their information provision regarding coping with stress, available local community support and medication purpose. Previously published literature was modified to address these gaps. Patients in the pilot study were satisfied with the re-designed booklet. Practitioners reported that its use in consultations enabled change implementation and facilitated patients’ understanding of connections between lifestyle and health outcomes.

Acknowledging the opinions of CHD patients in producing health information booklets emphasized a patient-centred approach and therefore supported practitioner–patient partnerships for choosing healthy lifestyle choices.

(Received July 08 2008)

(Accepted April 12 2009)

Key words

  • coronary heart disease;
  • health promotion communication;
  • primary health care;
  • qualitative research


c1 Correspondence to: Claire S. Leathem, Northern Ireland Clinical Research Network (Primary Care), Level 4 Dunluce Health Centre, 1 Dunluce Avenue, Belfast BT9 7HR, UK. Email: