People who see a GP do not get all the preventive health care they need. Here’s what might help
When you go to your regular GP, you’ll probably sit down, tell them about your health needs or issues, and they’ll advise and discuss with you how you can address them.
But one important aspect is missing from many GP visits: what you can do to prevent poor health in the future.
Preventive care includes counseling, such as quitting smoking or upcoming perimenopause; physical examination such as measurement of blood pressure, waist circumference or eyesight; high cholesterol tests or screening mammography (X-rays of the breasts); and treatments such as vaccinations.
We researched ways to better remind GPs and the people who see them about relevant preventative healthcare, and developed a solution that might help.
What are patients missing?
Just to give a few examples, only around half or less of eligible Australians currently take part in national screening programs for bowel, breast or cervical cancer.
Osteoporosis is a condition in which bones become weak and can break easily. This is a major health program that is common in the elderly, with osteoporotic fractures reducing the quality and length of life. Despite this, only around 10% of people at high risk of osteoporosis are screened by their GP.
Invasive pneumococcal disease is serious and sometimes fatal. Our research found that 30% of people under the age of 65 have chronic health conditions that put them at higher risk of pneumococcal infection, but only 24% of them report having received the pneumococcal vaccine. .
Why aren’t all recommended preventive care routinely offered?
National prevention guidelines indicate how often different activities should be performed for people of different ages and genders, making predictable when each relevant preventive activity is due for each person. Given this, why don’t most people know what preventative activities are recommended for them and when each should be done next? There are several reasons for this.
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One reason is that guidelines for the prevention, early detection or treatment of certain conditions are complex.
Second, recommended preventive measures change with age and as their personal and family medical history changes.
Preventative care is more likely to be offered during longer consultations, but Medicare’s Schedule of Benefits provides lower per-minute subsidies for longer consultations than for shorter ones. This increases out-of-pocket out-of-pocket expenses for longer consultations and discourages patients from seeking, and GPs from offering, longer consultations.
Currently, there is no place where each person can see a list of all the preventative health measures recommended for them, when each was performed, and when they should be taken.
Our research has developed a solution
Most electronic clinical record systems used by Australian GPs automatically generate on-screen reminders to GPs about preventative activities. These reminders only cover a limited range of preventive activities, are not very informative, and GPs can repeatedly ignore them without any liability.
Importantly, reminders are not automatically communicated to the patient. To solve this problem, we study the effects of the automatic sending of SMS messages to the patients on the preventive activities to be carried out.
Messages are sent after the person has made an appointment with their GP. They inform the person of the care that is due to him and advise the person to discuss it during his next consultation. These reminders empower their recipients and allow them to receive recommended care with minimal additional time, effort or cost.
Our previous studies of providing information and reminders on paper before consultations found that people were happy to receive this information and acted on it.
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GP clinical software systems should be improved to enable and encourage each person to view a comprehensive view of their preventive care updates. Currently, Doctors Control Panel on-screen reminder software for GPs (used in our research program) comes closest to providing a comprehensive list of recommended preventive activities for each person, and when they were or should be carried out.
What can you do now?
At least once a year you should ask your regular GP which preventive activities are recommended for you, when each was last performed with what result or finding, and when each should be performed next.
If you plan to do this when you go to see your regular GP for another reason, ask for a long appointment so your GP can find and give you this information.