May 2009


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

Mark F Harris

Amando Ampt

Rachel A Laws

Suzanne McKenzie

Anna M Williams

Upali W Jayasinghe

Nicholas A Zwar

Gawaine Powell Davies


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.


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.


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.


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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