Implementing guidelines to routinely prevent chronic disease in general practice (PEP study)

The intervention consists of:- 1. A training workshop for General Practitioners (GPs) and Practice Nurses (PNs) on prevention of vascular disease. The workshop is of 3 hours duration and is overseen and presented by a Primary Health Care specialist and Clinical Investigator in each state, the Intervention Facilitator (IF) and a Division of General Practice/Medicare Local staff member. The workshop introduces the 5As (Assess, Advise/Agree, Assist/Arrange) for smoking, nutrition, alcohol, physical activity, weight, blood pressure, cholesterol, diabetes, absolute cardiovascular risk and kidney disease. The format of the workshop is an introductory presentation followed by case studies and role plays using simulated patients. 2. Three practice visits of approximately 1-1.5hours duration each over 4 months will be provided by an intervention facilitator. The practice visits are designed to occur at regular intervals during the intervention period a) Practice visit 1 - 4 weeks post workshop b) Practice visit 2- 3-4 weeks after visit no 1 c) Practice visit 3 - 3-4 weeks after visit no 2 During the 4 months period the IF will also conduct 3 follow-up and troubleshooting phone calls with a member of the practice staff identified at visit no 1 to act as the 'prevention coordinator' This meeting with the practice staff is designed to: a) Review the baseline clinical audit report and identify areas for improvement b) Set some goals and plan for improvement c) Provide resources, referral links or support to help the practice d) Monitor improvements The training for GPs and PNs is designed to highlight the guideline recommendations relating to preventive activities in general practice. The practice is given baseline data which allows them to identify deficits in meeting these guideline recommendations and guided to identify ways in which they can modify their practice to deliver appropriate preventive care to their patients. Patients will receive the usual care of their practitioner but we would envisage that this care will be modified reflecting guideline recommendations provided through the training and additional resources.