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Clinical guidelines

Guidelines for preventive activities in general practice 9th edition

V. What's new in the 9th edition?

ChapterChange
1. Preventive activities prior to pregnancy

Advice on nutrition, weight assessment and oral health has been included in Table 1.1

Information on health inequity is presented under ‘What are the key equity issues and who is at risk?’ and ‘What can GPs do?’, highlighting the key issues and strategies

2. Genetic counselling and testing

Information on referral to clinical genetic services has been added

Inclusion of the use of a simple family history screening questionnaire to identify individuals in general practice who may require a more detailed assessment of their family history of cancer, heart disease or diabetes (Appendix 2A. Family history screening questionnaire)

Additional advice added regarding Down syndrome – for all pregnant women – hereditary haemochromatosis, haemoglobinopathies and thalassaemias (Table 2.1)Non-invasive prenatal test now included

3. Preventive activities in children and young people

Content has been edited and layout simplified to enable faster appreciation of the recommendations ‘at a glance’

Information on health inequity is presented under ‘What are the key equity issues and who is at risk?’ and ‘What can GPs do?’, highlighting the key issues and strategies

4. Preventive activities in middle age Information on health inequity is presented under ‘What are the key equity issues and who is at risk?’ and ‘What can GPs do?’, highlighting the key issues and strategies
5. Preventive activities in age

Falls and physical activity are now in separate sections

Physical activity recommendations relevant to the Australian environment are included

6. Communicable disease

Inclusion of new information on the consent process before vaccination

New information on the prevalence of chlamydia, gonorrhoea, syphilis and human immunodeficiency virus (HIV) in Australia

Information on health inequity is presented under ‘What are the key equity issues and who is at risk?’ and ‘What can GPs do?’, highlighting the key issues and strategies

7. Prevention of chronic disease

Additional information on identifying nutrition-related complications in children and adolescents (Table 7.3.1)

Change of title of Section 7.4 from ‘Problem drinking’ to ‘Early detection of at-risk drinking’. Additional advice and information on effective interventions

Section 7.5. Physical activity includes assessment advice and referral information for different age groups, and those at increased risk

Consumption of red meat and processed meat recommendations modified to align with World Health Organization (WHO) recommendations

Information on health inequity is presented under ‘What are the key equity issues and who is at risk?’ and ‘What can GPs do?’, highlighting the key issues and strategies

8. Prevention of vascular and metabolic disease

Information added on assessing need for anticoagulation (Table 8.5.2)

New information on atrial fibrillation

New advice about screening for diabetes based on US Preventive Services Task Force (USPSTF) guidelines

Information on health inequity is presented under ‘What are the key equity issues and who is at risk?’ and ‘What can GPs do?’, highlighting the key issues and strategies

9. Early detection of cancer

Sections rearranged in order of incidence – that is, most commonly reported in Australia

After reviewing information from recent large trials of prostate cancer screening, population screening for prostate cancer by prostate-specific antigen (PSA) testing continues to not be recommended. Therefore, GPs have no obligation to offer prostate cancer screening to asymptomatic men. Reference included to a decision aid to assist discussion of possible benefits and harms of screening with PSA in men who have individual concerns about prostate cancer

Inclusion of information on the cervical cancer screening program to commence in May 2017

New information about the risks and benefits of screening mammogram; in particular, the risk of over-diagnosis

Oral cancer section moved to Chapter 11. Oral health

Information on health inequity is presented under ‘What are the key equity issues and who is at risk?’ and ‘What can GPs do?’ highlighting the key issues and strategies

10. Psychosocial

Additional information on adolescents and those at average risk included for intimate partner violence (Table 10.3.1)

Information on health inequity is presented under ‘What are the key equity issues and who is at risk?’ and ‘What can GPs do?’, highlighting the key issues and strategies

11. Oral health Title of chapter has changed from ‘Oral hygiene’ to ‘Oral health’ to include information on both oral hygiene and cancer
14. Osteoporosis Inclusion of an additional section on quantitative ultrasound as an alternative imaging technique for assessing fracture risk
15. Screening tests of unproven benefit Additional screening tests not recommended:
  • Coronary computed tomography (CT) angiography for coronary artery disease
  • Cardiac calcium scoring for coronary heart disease
  • Thermography and single nucleotide polymorphisms testing for breast cancer
  • Optical colonoscopy and CT colonography for colorectal cancer
  • Heel ultrasound for osteoporosis
  • Carotid artery ultrasound for asymptomatic carotid artery stenosis
  • Enquiry about sleep for obstructive sleep apnoea
  • Bimanual pelvic exam during a routine Pap smear in asymptomatic women
  • Genetic testing for methylenetetrahydrofolate reductase (MTHFR)
  • Genetic testing for apolipoprotein E (ApoE)

‘Genetic profiling’ has been renamed ‘genomic sequencing’

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