Sleep

May 2009

Research

The 45 year old health check

Feasibility and impact on practices and patient behaviour

Volume 38, No.5, May 2009 Pages 358-362

Cheryl Amoroso BSc, MPH, is Research Fellow, Centre for Primary Health Care and Equity, University of New South Wales.

Mark F Harris MBBS, FRACGP, MD, Professor and Director, Centre for Primary Health Care and Equity, University of New South Wales and the Centre for Research Excellence in Obesity Management and Prevention in Primary Health Care, Sydney, New South Wales

Amando Ampt DipAppSc(Nurs), MHIM, is Research Officer, Centre for Primary Health Care and Equity, University of New South Wales.

Rachel A Laws BSc(Nutr), MSc(Nutr&Diet), is Research Fellow, Centre for Primary Health Care and Equity, University of New South Wales

Suzanne McKenzie MBS, MMedSci, GCULT, FRACGP, is Head of Discipline, General Practice and Rural Medicine, School of Medicine & Dentistry, James Cook University, Townsville, Queensland.

Anna M Williams DipAppSci(Nurs), MPH, is Research Fellow, Centre for Primary Health Care and Equity, University of New South Wales

Upali W Jayasinghe MSc, PhD, is Senior Research Fellow, Centre for Primary Health Care and Equity, University of New South Wales

Nicholas Zwar BBS, MPH, PhD, FRACGP, is Professor of General Practice, School of Public Health and Community Medicine, University of New South Wales.

Gawaine Powell Davies BA, MHP, is Associate Professor, Centre for Primary Health Care and Equity, University of New South Wales.

Background

The 45 year old health check (MBS item 717) for patients aged 45–49 years was introduced in 2006. This study evaluated its impact on preventive care and patient reported risk factors.

Methods

A quantitative and qualitative study was conducted in eight general practices in Sydney, New South Wales. It involved follow up surveys of 118 patients taken both before the check and 3 months after. Practice staff were trained and supported to conduct the health checks and appropriate interventions.

Results

There was ambivalence among some of the general practitioners toward the health check, but most found it feasible. The reported frequency of GP advice relating to each of the SNAP (smoking, nutrition, alcohol, and physical activity) risk factors increased; patient referrals, however, were infrequent. Patients’ readiness to change their diet and exercise habits improved as a result of the check, with respondents showing an increase in both the consumption of vegetables and the frequency of physical activity. There was no change in body mass index, smoking or alcohol consumption.

Discussion

The health check was associated with a short term improvement in diet and physical activity behaviours. Mechanisms to enhance referral need to be developed.

In 2004–2005, 90% of Australian adults had at least one, and 44% had at least three, of the following modifiable chronic disease risk factors (of): tobacco smoking, physical inactivity, low fruit or vegetable consumption, at risk alcohol intake, hypertension, high blood cholesterol or excess weight.1 While there is evidence supporting the feasibility of addressing these risk factors in general practice, due to lack of both specific funding and time required to support assessment and counselling, interventions of this nature are infrequent.2

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Correspondence afp@racgp.org.au

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