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Make every contact count by opportunistically asking about behavioural risk factors to prevent COPD

  • Making Every Contact Count (MECC) is an all-Wales approach to behaviour change, utilising day-to-day interactions, to support people to make positive changes that improve their physical and mental health and well-being.
  • Consider encouraging practice staff to acquire MECC skills. For MECC e-learning (to level 1), see here [ESR or other login/ registration required]. For MECC training contacts by health board, see here [intranet].
  • Brief intervention by staff in regular contact with people who could use some support to make informed choices is promoted by NICE guidance (PH49). 
  • Optimise primary/ secondary preventive actions for smoking (BRF-001) in particular; also for unhealthy diet (BRF-002), physical inactivity (BRF-003) and alcohol misuse (BRF-004) as contributors to overweight and obesity (noting that exercise may also trigger asthma).
  • Smoking significantly increases the risk of asthma in adults and significantly increases the risk of asthma exacerbations in adults and pregnant populations; passive smoke increases the risk of asthma in children (Chest 2016 Jul;150(1):164–79).
  • The importance of reducing these behavioural risk factors is reiterated in the Respiratory health delivery plan (WG 2018). Of particular relevance to primary care clinicians, the plan recommends actions include improving referral rates to smoking cessation services, pulmonary rehabilitation programmes, and to the National Exercise Referral Scheme (NERS) or local exercise programmes.