Preventive health – key points

Consider the evidence base for medical tests used in preventive activities

  • A range of assessments and pathology tests is recommended for people aged 40–49 who are not already known to be at high risk. In the RACGP red book guidelines, for example:
    • AUSDRISK to assess risk of developing type 2 diabetes
    • lipid testing to calculate absolute cardiovascular risk (for people aged over 45, or 35 for Aboriginal and Torres Strait Islander peoples)
    • pap testing to screen for cervical cancer.
  • However, some tests are not recommended for routine testing in asymptomatic and/or low-risk people because the harms of testing may be greater than the benefit. For example, prostate cancer screening using the PSA test, vitamin D test and full blood count.
  • It is important that preventive healthcare focuses on the tests that are evidence based and have proven benefits for patients.

Actively review patients to assess for individual risk factors

  • Preventive activities need to be targeted at individual needs.
  • Focus on higher-risk groups, in particular:
    • indigenous people
    • those from low socioeconomic backgrounds
    • those with a premature family history of cancer or cardiovascular disease
    • those with known risk factors.
  • Target specific preventive activities appropriate for the age and population group. For example, in most people aged 40–49 concentrate on SNAPW risk factors, diabetes and cardiovascular disease prevention and cervical cancer screening.

Review your system to enhance preventive activities in your practice

  • Optimal model of care involves both opportunistic and planned preventive activities at particular ages and for higher-risk populations.
  • Planned preventive activities can improve identification of people with multiple risk factors.
  • Following up after assessment is essential to link to an effective intervention, potentially using the 5As framework: assess, advise, agree (set goals), assist (refer) and arrange (follow-up).

For more information

  1. Best Practice NZ. Best Tests? The general principles of laboratory investigations in primary care. 2013.