Preventive activities in general practice 7th edition | Preventive activities in middle age

Introduction and user guide

Preventive activities before pregnancy

Genetic counselling and testing

Preventive activities in children and young people

Preventive activities in middle age

Preventive activities in older age

Communicable diseases

Prevention of chronic disease

Prevention of vascular and metabolic disease

Early detection of cancers

Psychosocial

Screening tests of unproven benefit

Appendices

Disclaimer

Preventive activities in middle age

Preventive activities in middle age age range table

Age

0 - 9

10 - 14

15 - 19

20 - 24

25 - 29

30 - 34

35 - 39

40 - 44

45 - 49

50 - 54

55 - 59

60 - 64

65 - 69

70 - 79

>80

The recommended specific activities for low risk patients in the 45–64 years age group are listed below. Patients should be offered these opportunistically or at 2–5 year intervals (B). Planned health checks in middle aged adults have been demonstrated to improve the frequency of management of SNAP behavioural risk factors, screening for cervical and colorectal cancer, and hyperlipidaemia in general practice.^7,126,127However, there is mixed evidence for their effectiveness. These checks may be facilitated by the involvement of practice nurses.^128–130

Preventive activities in middle age: Risk
Age	Recommendation	Cross reference page
45–49 years	Assess SNAP behavioural risk factors Risk of diabetes (AUSDRISK questionnaire) and absolute CVD risk Depression in increased risk groups (eg. past history, physical illness, other mental problems) Risk factors for osteoporosis Skin cancer Measure Weight, height (calculate BMI) and waist circumference Blood pressure Fasting lipids Fasting blood glucose in patients at high risk of diabetes Perform Pap test every 2 years Mammography if family history indicates high risk	32–34 44 + Appendix 2 + 3 58–59 65 48–50 34–35 42–43 43 44 51–52 52–53
50–64 years	Assess SNAP behavioural risk factors Risk of diabetes (AUSDRISK questionnaire) and absolute CVD risk Depression in increased risk groups (eg. past history, physical illness, other mental problems) Risk factors for osteoporosis Skin cancer Measure Weight, height (calculate BMI) and waist circumference Blood pressure Fasting lipids Fasting blood glucose in patients at high risk of diabetes Urinalysis for protein Perform Pap test every 2 years Colorectal cancer screening with faecal occult blood testing (FOBT) at least every 2 years Mammography every 2 years Vaccination for diphtheria/tetanus/acellular pertussis (dTpa). Consider influenza and pneumococcal vaccination if high risk	32–34 44 + Appendix 2 + 3 58–59 65 48–50 34–35 42–43 43 44 46–47 51–52 54–55 52–53 28

Preventive activities in middle age: Risk

Age

Recommendation

Cross reference page

45–49 years

Assess

SNAP behavioural risk factors
Risk of diabetes (AUSDRISK questionnaire) and absolute CVD risk
Depression in increased risk groups (eg. past history, physical illness, other mental problems)
Risk factors for osteoporosis
Skin cancer

Measure

Weight, height (calculate BMI) and waist circumference
Blood pressure
Fasting lipids
Fasting blood glucose in patients at high risk of diabetes

Perform

Pap test every 2 years
Mammography if family history indicates high risk

32–34
44 + Appendix 2 + 3
58–59

65
48–50

34–35
42–43
43
44

51–52
52–53

50–64 years

Assess

SNAP behavioural risk factors
Risk of diabetes (AUSDRISK questionnaire) and absolute CVD risk
Depression in increased risk groups (eg. past history, physical illness, other mental problems)
Risk factors for osteoporosis
Skin cancer

Measure

Weight, height (calculate BMI) and waist circumference
Blood pressure
Fasting lipids
Fasting blood glucose in patients at high risk of diabetes
Urinalysis for protein

Perform

Pap test every 2 years
Colorectal cancer screening with faecal occult blood testing (FOBT) at least every 2 years
Mammography every 2 years
Vaccination for diphtheria/tetanus/acellular pertussis (dTpa). Consider influenza and pneumococcal vaccination if high risk

32–34
44 + Appendix 2 + 3
58–59

65
48–50

34–35
42–43
43
44
46–47

51–52
54–55

52–53
28

Preventive activities in middle age: Intervention
Intervention	Technique	References
Health education	Tailor health advice or education to the patient’s stage of change (see VI Patient education and health literacy)	131
Practice organisation	Identify patients who have not had preventive activities. Flag medical record; recall patient to practice. Assessment and education may be delegated to other practice staff	132

Preventive activities in middle age: Intervention

Intervention

Technique

References

Health education

Tailor health advice or education to the patient’s stage of change (see VI Patient education and health literacy)

131

Practice organisation

Identify patients who have not had preventive activities. Flag medical record; recall patient to practice. Assessment and education may be delegated to other practice staff

132

Preventive activities in middle age: Health Inequality
Health inequality
Aboriginal and Torres Strait Islander and low SES patients have a higher risk of disease but are less likely to be offered preventive interventions.
Strategy Strategies to increase screening and effective motivational and behavioural interventions in this group are discussed in the ‘green book’.

Preventive activities in middle age: Health Inequality

Health inequality

Aboriginal and Torres Strait Islander and low SES patients have a higher risk of disease but are less likely to be offered preventive interventions.

Strategy
Strategies to increase screening and effective motivational and behavioural interventions in this group are discussed in the ‘green book’.

Guidelines for preventive activities in general practice 7th edition

Full index

Introduction and user guide

Preventive activities before pregnancy

Genetic counselling and testing

Preventive activities in children and young people

Preventive activities in middle age

Preventive activities in older age

Communicable diseases

Prevention of chronic disease

Prevention of vascular and metabolic disease

Early detection of cancers

Psychosocial

Oral hygiene

Glaucoma

Urinary incontinence

Osteoporosis

Screening tests of unproven benefit

References

Appendices

Glossary

Acronyms

Acknowledgements

Disclaimer

Preventive activities in middle age