The advising behaviour of healthcare professionals; considerations of dieticians and general practitioners regarding dairy and probiotic interventions

Dairy and probiotics are examples of products that contain ingredients that provide health benefits beyond the basic nutritional components of the food itself. However, strong evidence based on randomised controlled trials is generally lacking, which in turn leads to weak guidelines and recommendations for clinical practice. Interestingly, despite the limited regulation of probiotics, for example, a significant proportion of healthcare professionals still recommend these products. We set out studying the advising behaviour of general practitioners (GPs) and dieticians and their underlying motivations whether to advise probiotics, a relatively new intervention, and dairy, an older intervention by conducting interviews and setting out a questionnaire. This study found that the vast majority of GPs and dieticians recommended dairy and probiotics. The proportion of dieticians that do not advise both dairy and probiotics was too small for statistical analysis, therefore, the results are mainly focused on GPs. Considerations that appeared to be associated with GP advising behaviour were related to compliance with protocols and guidelines in regard to both dairy and probiotics. For probiotics in particular, GPs' knowledge and patients' interest in using probiotics was related to advising behaviour of GPs. Considerations solely related to recommending dairy were related to GPs' perceptions about the amount of evidence of dairy efficacy and the recommendation of dairy in scientific journals. The study highlights the influence of authority-driven, expertise-driven and patient-driven considerations on whether or not to proceed with recommending an intervention. Insights into the drivers of GPs to advise, gives input to stakeholders in the nutrition innovation system to understand and allow to use appropriate tools to support GPs in making an informed decision to increase the quality of care provided.