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Guidelines for preventive activities in general practice (The Red Book) 6th Edition 2005

The recommendations in these guidelines are based on current evidence based guidelines for preventive activities. Precedence has been given to those that are most relevant to Australian general practice. Usually this means that the recommendations are based on Australian guidelines such as those endorsed by the National Health and Medical Research Council (NHMRC). In cases where these are not available, or recent, other Australian sources have been used such as the National Heart Foundation of Australia or Canadian or US preventive guidelines. References to support these recommendations are listed. However, particular references may relate to only part of the recommendation (eg. only relating to one of the high risk groups listed) and other references in the section may have been considered in formulating the overall recommendation.

Recommendations are consistent with the Medicare Benefits Schedule at the time of writing. Comprehensive annual health assessment is currently approved for those 75 years of age and over (items 700 and 702) and Aboriginal and Torres Strait Islander peoples 55 years of age and over (items 704 and 706). The new Aboriginal and Torres Strait Islander adult health check (item 710) provides for 2 yearly health checks for those aged 15–54 years of age inclusive. However, preventive activities appropriate for age and risk status may also be provided opportunistically to patients as part of normal consultations. For example it is appropriate to check if a particular patient has been recently screened for cancer when they present for other conditions, and screen at that or a subsequent visit. It is also appropriate to assess risk factors such as smoking, physical inactivity or overweight, and offer interventions during the same or subsequent consultations if indicated.

Structure

These guidelines are designed for ease of use during the consultation. This 6th edition provides ‘what is new’ and ‘how to use’ sections. The folded chart provides an overview of what activities are recommended at each age of the lifecycle. Details are listed under each activity consisting of a paragraph summarising key recommendations and a table outlining the details. The guidelines are available (with links to additional information on the source guidelines) on the RACGP website at www.racgp.org.au/redbook

Scope and limitations

These guidelines have not included tertiary prevention or detailed information on the management of risk factors or early disease (eg. what medications to use in treating hypertension). Similarly it has not made recommendations about tertiary prevention (ie. preventing complications in those with established disease). Also, information about prevention of infectious diseases has been limited largely to immunisation and some sexually transmitted infections. There is limited advice about travel medicine. Information on travel medicine can be obtained from the Centres for Disease Control at www.cdc.gov/travel/index.htm or WHO International Travel and Health at www.who.int/ith

These recommendations are based on the best available information at the time of writing. On past experience this means that the guidelines will remain current for no more than 2 years. Any update information will be posted on the RACGP website. Australian readers can find other information and guidelines on the NHMRC website at www.health.gov.au and the Cochrane Collaboration at www.cochrane.org.au

Publication Date: 18 November 2005