Health check recommendations

• Perform following on Aboriginal and Torres Strait Islander people > 15 years annually and all other people > 45 years opportunistically:
  • blood glucose level (BGL)
  • lipid profile
  • kidney function
  • STI screen
• Ensure all people 50–74 years are participating in the National Bowel Cancer Screening Program. If not perform faecal occult blood test (FOBT)
• Ensure all Aboriginal and Torres Strait Islander people aged > 15 years have been tested once for Hepatitis B

1. Procedure

• If person meets health check recommendations, undertake the test(s) according to local and universal precaution policies. See Table 1.
• Be prepared to explore issues. See Engaging our patients
• Provide brief intervention education if a specific need is identified
• Determine if the person requires a referral and place onto a follow-up and recall register

1. BGL ^1–4
   • Take venous blood and request ‘Glucose’ on the pathology form
   • Once results return, manage as per Diabetes
2. Lipid profile ^5–7
   • Take venous blood and request ‘Lipid profile’ on the pathology form
   • Once results return, manage as per Dyslipidaemia
3. Kidney function ^8–11
   • Take venous blood and request ‘Creatinine’ on the pathology form
   • Perform a first catch mid-stream urine:
     • if positive for protein send remaining urine to pathology requesting ‘Albumin creatinine ratio’ on the pathology form. Once results return, manage as per Chronic kidney disease
     • if positive for nitrites add ‘MCS’ on the pathology form. Once results return, manage for possible urinary tract infection as per the Primary Clinical Care Manual
4. Bowel cancer ¹²
   • For all people aged 50–74 years, check they are receiving and using the National Bowel Cancer Screening Program kits mailed to them every 2 years. See Resource 1. for patients to order a replacement kit
   • If not, provide the patient with a faeces container to collect a stool sample
   • Instruct patient to keep sample refrigerated (2–8°C) and return to health centre within 24 hours
   • Once returned to health centre, request ‘FOBT’ on the pathology form
5. HBV serology ^13–16
   • If documented evidence of hepatitis B serology exists, no need to test. Refer to Hepatitis B
   • Pregnant women are screened antenatally. See the Primary Clinical Care Manual
   • Take venous blood and request ‘HBsAg, anti-HBs, anti-HBc and anti-HBc IgM’ on the pathology form. Add any previous vaccinations or risk factor history
   • Once results return, manage as per Hepatitis B
6. Syphilis serology ^17,18
   • For sex workers in Queensland, testing is recommended every 3–6 months
   • Pregnant women are screened antenatally. See the Primary Clinical Care Manual
   • Take venous blood and request ‘TPGE’ on the pathology form
   • Once results return, manage as per Primary Clinical Care Manual
7. HIV serology ^17,18
   • For sex workers in Queensland, testing is recommended at least twice a year
   • Take venous blood and request ‘HIV antibodies–serology’ on the pathology form
   • Once results return, manage as per Primary Clinical Care Manual
8. Trichomonas, chlamydia and gonorrhoea ^17,18
   • For sex workers in Queensland, testing is recommended every 3 months
   • Take urine and request ‘Urine PCR for chlamydia, gonorrhoea and trichomoniasis’ on the pathology form
   • Once results return, manage as per Primary Clinical Care Manual

2. Results, brief intervention and referral

• Refer to the MO/NP for any abnormal results for:
  • BGL. See Diabetes
  • lipid profile. See Dyslipidaemia
  • hep B serology. See Hepatitis B
  • ACR, eGFR, Creatinine. See Chronic kidney disease
  • Syphilis, HIV, trichomonas, chlamydia or gonorrhoea, see the Primary Clinical Care Manual
  • FOBT

3. Follow-up

• Place the person on a recall register if required
• Ensure all referrals are actioned
• Provide the person with details for the next scheduled follow-up appointment

4. References

• All Chronic Conditions Manual references are available via the downloadable References PDF

5. Resources

1. Order a replacement bowel cancer screening test kit
2. Aboriginal and Torres Strait Islander National Bowel Cancer Screening resources for clinicians
3. Priority HBV testing CALD communities
4. The Queensland Health statewide pathology website for detailed specimen collection guides
5. Red Book: STI & BBV Resources For Sex Workers By Sex Workers