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Influenza immunisation – annually
Pneumococcal immunisation
Herpes Zoster Vaccine (Shingles) – funded for 70-79 years old
Pertussis – funded for certain cohorts
Falls Risk Factors – Stay on your feet
• Have there been any near misses?
• Review anticholinergic medications and sedatives
• Check sitting and standing blood pressure
• Reduce tripping risks – consider footwear, eyewear, night lighting, other hazards.
• Gait and Balance problems – observe ‘get up and go’ for all patients.
Referral to Falls and Balance clinic https://gcphn.org.au/referrals/falls-balance/
FRAX – Fracture Risk Assessment Tool
• Vitamin D and adequate (or supplemented) calcium should be prescribed for any patients taking osteoporosis medications.
• Loss of height > 3cm merits spine x-ray
• For exercise to improve bone density regular high-intensity resistance training is needed.
Osteoporosis resources
MBS Bone density guidelines
Fracture risk calculator
Osteoporosis Australia – RACGP Guidelines
Chronic Kidney Disease Management Handbook
• Confirm eGFR checked in the last 12 months
• If chronic kidney disease is present, add this as a coded diagnosis.
Polypharmacy Guidance – Medicines Review
• Consider checking for low sodium levels
• Review or complete Geriatric Depression Scale to monitor/manage depression.
Clinical practice guidelines for people with dementia
Geriatric Depression Scale
RACGP The Red Book
Heart Foundation Hypertension Guidelines – observational studies show no mortality benefits of antihypertensive medication in the frail elderly. The standard treatment target for the elderly <150/90.
RACGP Green Book
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