The causes of chronic disease are largely attributable to risk factors such as smoking, misuse of alcohol, nutrition and physical activity.57 There is a plethora of evidence indicating the impact of GPs on these risk factors at patient and population levels. Despite a range of initiatives in general practice including those related to MBS items for preventative care, uptake is less than optimal.58,32
The role of GP Super Clinics in relation to preventative health care has been mainly in relation to secondary prevention. In particular, it has been focused on reducing risk factors and improving self-management in patients with chronic illness.
The results from this evaluation suggest a number of issues in relation to preventative care in the GP Super Clinics. The first is potentially a lack of understanding of preventative care in the context of the whole patient population, particularly regarding primary prevention for patients without disease. Second, results suggest a lack of focus on preventative care in general in the GP Super Clinics to date. This may be understandable in the context of their maturity, with other priorities, particularly those related to chronic disease management, considered more important. Third, the lack of data about patient populations’ risk factors, limits options for a focus on primary prevention. If these data were used they could potentially drive priorities and strategies for primary prevention. These data are potentially available in the GP Super Clinics’ electronic health record systems, but their use in terms of the patient population and risk factors has not been realised. Last, financial reasons related to MBS items for preventative health care, were commonly quoted as barriers to preventative care.
Regardless of the reasons, these results suggest missed opportunities for preventative care, particularly for primary prevention. Hence, the potential for reducing the future burden of disease in the patient populations and in the communities served is not currently being achieved.
32Booth A, Nowson C. Patient recall of receiving lifestyle advice for overweight and hypertension from their General Practitioner. BMC Family Practice.11(1):8
57Australian Institute of Health and Welfare: Indicators for chronic diseases and their determinants. Canberra: Australian Institute of Health and Welfare;2008.
58Ampt A, Amoroso C, Harris M, McKenzie S, Rose V, Taggart J. Attitudes, norms and controls influencing lifestyle risk factor management in general practice. BMC Family Practice. 2009;10(1):59.