The role of Australian primary health care in the prevention of chronic disease

Primary health care has an important role in assessing, preventing and managing smoking, hazardous drinking, poor diet and physical inactivity. The 5As (ask, assess, advise/agree, assist and arrange) provide a framework for analysing the steps involved in preventive care and in defining the optimal roles of providers and services at the practice level. There is evidence for the effectiveness of interventions provided by practice nurses, allied health providers and group programs. However these providers are currently under-utilised in preventive care and more effective teamwork within and between primary health care services is needed. Information systems including e-health records, decision support and web tools and resources facilitate a systematic approach to preventive care. Despite evidence of how to prevent chronic disease in primary health care, there remain gaps in preventive care in practice and inequities in access to preventive care by disadvantaged population groups. The role of Medicare Locals is to facilitate practice change, as well as to develop partnerships with state health services, local government and non-government organisations to coordinate and broker new preventive services and programs and to integrate clinical and population health approaches to prevention. Reforms to funding, workforce, patient enrolment, and primary care organisation and structure remain important to the implementation and maintenance of preventive activities in primary health care.