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Components of the 45-49 Health Check
Update & Assess
Aboriginal or Torres Strait Islander Background
Needed in order to determine diabetes risk.
Allergies
Medications, Foods and Insects.
Family History
Prompt for Cancer, Heart Disease, Diabetes Type 1 & 2 and musculoskeletal conditions.
Smoking 
Number of cigarettes, Frequency and Stage of Quitting (Not ready, Unsure: next 6 months, Ready: within 1 month)
Alcohol 
Number of drinking days in a week, Number of Drinks in a day, Frequency of 4+ at once.
Exercise 
Intensity of Activity, Frequency (should be most days) and Duration of activity.
Nutrition 
Portions of fruit & vegetables per day, Frequency of Take out/fried food/pastries, Frequency of Soft drinks, cordials or juices.
Skin Cancer risk 
Family Hx of Melanoma, newly grown lesions or changed in appearance in recent months.
Osteoporosis risk 
Previous low trauma fracture, low body weight, limited sun exposure.
Pap smears up to date (Women only) (Red Book p.51) Within the last 2 years.
Last Mammography (Women only if Family Hx of Breast Ca) (Red Book p.53)
Last Cholesterol check: (Red Book p.43)
Last Blood Glucose check: (Red Book p.44)
Confirm Medication list: Correct medication and doses recorded in patient file.
Screen for Depression 
Over the past 2 weeks have you:
Felt down, depressed or hopeless?
Felt little interest or pleasure in doing things?
Measure
Weight, Height, Waist & BMI:(Red Book p.34)
Blood Pressure (Red Book p.42):
Calculate Diabetes risk with AUSDRISK Tool :
Calculate Cardiovascular risk with CVD Risk Tool (Red Book p.92):
Recommended Investigations (Red Book p.22)
Fasting Blood Glucose Level (if diabetes risk)
Fasting Cholesterol

Area
Smoking
(SNAP p.10)
Guidelines
Patients who smoke (regardless of the
amount they smoke) should be offered brief
advice to stop smoking.
Referral pathways/services
Quitline – 131 848 or www.quitnow.info.au
Follow up
1 week
then
1 month
Alcohol and Drug Direct Line 1800 888 236
Alcohol
(SNAP p.21)
Men: maximum 4 standard drinks/day (28/wk)
Women: 2 standard drinks/day (14 per week)
Alcoholics Anonymous www.aa.org.au
1-3 Months
Southcity Clinic: 9525 7399
Add the total minutes of brisk walking,
moderate and/or if doing vigorous physical
activity then multiply x2.
Exercise
(SNAP p.24)
Nutrition
(SNAP p.17)
Skin Cancer
(Red Book p.49)
Osteoporosis
(Red Book p.65)
Depression
(Red Book p.58)
Diabetes risk
(Red Book p.44 &
p.88.
Diabetes
Management in
GP 09/10 p.9)
Total minutes needs to be equal or more
than 150 minutes per week over five or
more sessions per week.
Heartline – 1300 36 27 87
Exercise Physiologists www.aaess.com.au
3-6 months
Advise moderate physical activity on most,
preferably all days of the week for an
accumulated time of 30 minutes per day. This
can be achieved in 3x10 minute sessions.
Brisk walking for 30 minutes most days of
the week would be ideal.
www.sport.vic.gov.au/web/srv/srvsite.nsf/pages/srvhome
Bread, cereals, rice, pasta, noodles
4serves/day
Vegetables, legumes 5serves/day
Fruit 2 serves/day
Milk, yoghurt, cheese 2 serves/day
Meat, fish, poultry, eggs, nuts 1 serve/day
Dietitian www.daa.asn.au or 1800 812942
http://www.betterhealth.vic.gov.au
Heartline – 1300 36 27 87
http://www.betterhealth.vic.gov.au
2-3 months
www.nutritionaustralia.org/default.htm
Advice on protective measures: use of shade, hat; protective clothing; sunglasses; and SPF 30+sunscreen (to
be reapplied every 2 hrs).
Skin examination should be preceded by inquiry for patient concern, eg. of newly grown lesions or change in
appearance of any lesions in the past few months (evolution).
Examination should assess asymmetry, border, colour, diameter and elevation (ABCDE). Lesions that are
asymmetric, have an irregular border, variation in colour or have a red halo, are >6 mm or elevated, are possibly
melanomas.
Also to identify nodular melanoma use ‘EFG’ (elevated, firm, growing for more than 1 month). The mole that
stands out from the others (the ‘ugly duckling’ sign) has been found to be a useful sign.
12 months
Provide advice regarding risk factor modification, especially a good general diet high in calcium (1000–1500
mg/day) and vitamin D, adequate levels of physical activity, smoking cessation and limited alcohol and
caffeine intake.
Offer modest calcium with vitamin D supplements to those with poor diet and limited sun exposure.
12 months
If YES to either question, further assessment might be required.
Refer for GP assessment. Might be eligible for a GP Mental Health Plan and subsequent referral to Psychology
services.
http://www.beyondblue.org.au
http://www.blackdoginstitute.org.au
1 -3
months
If AUSDRISK score is 12+ patient may be eligible for a Lifestyle Modification Program (LMP), but a diabetes
diagnosis must first be excluded:
Fasting or Random glucose <5.5 or Oral Glucose Tolerance Test <11.0
For more information on LMP’s visit www.mylmp.com.au
Advice: • Increasing physical activity (eg. 30 minutes brisk walking 5 times per week) and/or weight loss
reduces risk of developing diabetes by 40–60% in those at high risk.
• Give advice on a healthy low fat diet (<30% kcal from fat and <10% from saturated fat). High fibre, low
glycaemic index with cereals, legumes, vegetables, fruits, weight loss and increased physical activity (see SNAP
guidelines)
• Refer patients to a dietician and a physical activity program
3 years
This table is current at time of printing October 2011