RACGP releases new preventive guidelines for GPs

The Royal Australian College of GPs (RACGP) has launched the 10th edition of its ‘Red Book’, the Guidelines for preventive activities in general practice for GPs.

The new edition of the widely used resource builds on its long history of guiding preventive activities in general practice. It includes recommendations on evidence-based screening, prevention of chronic disease, early detection of disease and empowering patients through health education and promotion.

Changes in the 10th edition include:

• New topics, including developmental delay and autism; child and elder abuse; anxiety; gambling; sleep; eating disorders; several new women’s health topics in relation to preventive care during and after pregnancy; and post menopause.
• Adoption of the internationally recognised GRADE framework to ensure recommendations are written to be actionable and use of this gold standard for grading recommendation strength and direction.
• A standardised topic format and word limit to ensure recommendations are concise and uniform.
   

RACGP Red Book Chair and Head of the Department of General Practice at Monash University Professor Danielle Mazza AM said a new more rigorous approach was used in the development of the new edition and the format redesigned to make information more accessible.

“The Red Book is the key resource for preventive healthcare in general practice,” Mazza said.

“In developing this new edition, we have used a clearer more consistent format so GPs can quickly access and review best practice advice on a wider range of conditions.

“I’m really proud of the work the teams of expert GPs have done for this edition. This includes adopting GRADE, a new recommendation system in line with other guidelines around the world, and rigorously reviewing all topics to ensure they’re consistent, concise, evidence based and implementable was an enormous project. The result is a Red Book that’s easier to rapidly review and apply in practice. Feedback has been very positive, with GPs loving the online searchable format.

The changing GP landscape

“The new topics we have introduced in this edition also reflect the changing landscape of general practice and our patients. Mental health presentations were recorded as the most common issue in general practices in the RACGP Health of the Nation report for the sixth consecutive year, with 38% of consultations including a mental health component. In 2020–22, 1.9 million people sought professional help for mental health, and GPs were the most common health professional they sought out,” Mazza said.

“Alongside new topics in mental health, cancer and more, we have also greatly expanded the preventive health topics in women’s health. GPs are a patient’s key provider at all stages of a woman’s life, so new guidance on preconception care, the first antenatal visit, throughout pregnancy, health between pregnancies and postnatal mental health will be key resources for GPs. Menopause has been an area where women have historically been underserved in the health system, so guidance on preventive health around post menopause will be welcome.”

Call for funding

The RACGP has called for funding to create living guidelines for GPs so patient care is consistently updated from the latest evidence as it is published. RACGP President Dr Nicole Higgins said this would help GPs to stay at the forefront of medical best practice.

“Health research and evidence change rapidly,” Higgins said.

“GPs see hundreds or thousands of patients a year, so a delay between quality research being published and being reviewed and incorporated into guidelines means missed opportunities. The volume and breadth of medical research publishing means an update requires significant work by experts, with appropriate resourcing and support.

“Getting that support in place for the RACGP will pay dividends in not just better health and quality of life, but in disease prevention and management in the community.

“The leading causes of death and disability in Australia are preventable or can be delayed with early intervention. Funding for RACGP guidelines and for preventive interventions in general practice will mean Australians get the latest evidence-based care — this will make Australia healthier and reduce costs to the health system.”

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