GP Chronic Condition Management Plan
0.1.0 - CI Build

GP Chronic Condition Management Plan, published by AEHRC CSIRO. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/aehrc/gpccmp-fhir-ig/ and changes regularly. See the Directory of published versions

Example QuestionnaireResponse: QuestionnaireResponse - GP Chronic Condition Management Plan

GP Chronic Condition Management Plan

Patient: Caterina FOREMAN
Author: Dr Peter Primary
Date Authored: 17/08/2026 11:36

Patient details

Consent

Consent given to proceed with plan after discussion of the purpose, benefits, process and costs
Yes

Name
Caterina FOREMAN

Preferred pronouns
she/her/her/hers/herself

Date of birth
24/07/1970

Age
55

Sex assigned at birth
Female

Gender identity
Identifies as female gender

Aboriginal and/or Torres Strait Islander status
Neither Aboriginal nor Torres Strait Islander origin

My Aged Care

Registered for My Aged Care
No

National Disability Insurance Scheme

Registered for NDIS
No

Medicare card number

NumberReference numberExpiry
395133370112028-08

Contact information

Home phone
  • 0370109077
Mobile phone
  • 0491576801
Email
  • caterina.foreman@my-own-personal-domain.com

Home address

Home address

Street addressCityStatePostcode
149 Farmer CnrSunshineVictoria3020

Carers and key contacts

Preferred contactRoleNamePhoneEmailRelationship to patientPresent at appointment
YesContact person
Carer
Mia LEANNE BANKS0270107520
0491574632
0270102724
Emergency ContactHeather MACKAY0370108075
0491578148
0370103228

Practitioner details

Name
Peter Primary

Phone
  • (08) 7010 5556
Email
  • PPP@example.org
Medicare provider number
  • 2426621B

Clinic details

Name
Quinninup Medical Clinic

Address

Street address
24 Grande Pl

City
Quinninup

State
Western Australia

Postcode
6258

Clinical details

Problems/Diagnoses

Recorded problems/diagnoses

ConditionClinical statusOnset dateAbatement date
Chronic lower back painActive01/01/2021
Gastro-oesophageal reflux diseaseActive01/08/2013

New problems/diagnoses

ConditionOnset dateComment
Uncontrolled type 2 diabetes25/01/2026
Peripheral neuropathy due to diabetes20/02/2026
Overweight25/11/2025

Adverse reaction risks

Recorded adverse reaction risks

SubstanceStatusManifestationComment
LatexActiveRashHas reacted soon after exposure as well as a delayed reaction to latex, with a rash appearing 24 hours after exposure.

Medications (current)

Recorded medications

MedicationStatusDosageIndicationComment
Panadol Osteo 665 mg modified release tabletActive2 tabs PRN/TDSChronic lower back pain
Panadol Osteo 665 mg modified release tabletActive2 tabs PRN/TDSChronic lower back pain
Esomeprazole 20 mg enteric capsuleActive1 tab dailyGastro-oesophageal reflux diseaseGastroscopy 2013 - mild reflux esophagitis, H pylori negative

New medications

MedicationDosageIndicationComment
Metformin hydrochloride 500 mg tablet1 tab BDUncontrolled type 2 diabetes
Fish oil2 caps dailySelf-initiated for heart health

Observations

Observations

Height

New result
165 cm

New result date
17/08/2026

Weight

New result
75.2 kg

New result date
17/08/2026

BMI (calculated)

New result
27.6 kg/m2

Waist circumference

New result
82.5 cm

New result date
17/08/2026

Pulse rate

New result
76 /min

New result date
17/08/2026

Pulse rhythm

New result
Pulse regular

New result date
17/08/2026

Oxygen saturation

New result
98 %

New result date
17/08/2026

Blood pressure

Blood pressure

Systolic
130 mm[Hg]

Diastolic
72 mm[Hg]

Date performed
17/08/2026

Substance use

Smoking status

Comment
20 cigarettes per day since 17yo

Alcohol consumption status

Comment
2 drinks, 2 days per week (on weekends)

Additional information
Family history: Mother - diabetes, stroke; Father - heart attack, depression; Paternal grandmother - breast cancer Work: Receptionist in building business

Plan

New plan or a review of an existing plan?
New

Incomplete draft plan already exists?
Yes

Conditions addressed

ConditionOnset dateComments
Uncontrolled type 2 diabetes25/01/2026
Chronic lower back pain01/01/2021
Gastro-oesophageal reflux disease01/08/2013
Overweight25/11/2025

Goals and tasks

Problems/Needs
  • Uncontrolled type 2 diabetes
  • Hyperglycaemia
  • Peripheral neuropathy due to diabetes
  • Overweight

Goal setting

GoalsInitiatorTarget dateStatusComment
Controlled diabetes - aim HbA1c ≤7.0 and fasting BGL 4.0-7.0GP20/05/2027active

Interventions and actions

Interventions/ActionsOwnerTarget dateStatusComment
Diabetic educationCaterina, diabetes educator20/08/2026Planned
Diet educationCaterina, dietitian20/08/2026Planned
Exercise regimeCaterina, exercise physiologist20/11/2026PlannedAim for 150 mins moderate physical activity per week
Weight management programCaterina, GP20/05/2027PlannedAim for 5-10% weight loss, waist circumference <80cm
Diabetes medicine reviewCaterina, GP, pharmacist20/08/2026PlannedConsider Home Medicines Review in 3-6 months
Metformin therapyCaterina, GP, pharmacist03/06/2026Planned
Detecting complications earlyCaterina, GP, podiatrist, optometrist20/05/2027PlannedRegular screening for diabetic nephropathy, neuropathy and retinopathy

Services and treatments

Required services and treatmentsActivityProviderComment
Diabetes education serviceReferral to diabetes nurseDiabetes educator
Diabetes education serviceDiabetes diet educationDiabetes educator
Dietetics serviceReferral to dietitianDietitian
Dietetics serviceDiet educationDietitian
Exercise physiology serviceReferral to exercise physiologistExercise physiologist
Exercise physiology serviceExercise regimeExercise physiologist
Medicine review serviceReferral to pharmacistPharmacist
Medicine review serviceHome medicines reviewPharmacistConsider Home Medicines Review in 3-6 months
General practice serviceOngoing reviewGP, practice nurse
Problems/Needs
  • Uncontrolled type 2 diabetes
  • Overweight
  • Gastro-oesophageal reflux disease
  • Chronic lower back pain
  • Low self-esteem

Goal setting

GoalsInitiatorTarget dateStatusComment
5-10% weight loss (target weight 73.8-77.9kg) and decrease waist circumference (long term target <80cm)GP20/05/2027active
Comfortably wear dress purchased for niece’s wedding next yearCaterina20/05/2027active

Interventions and actions

Interventions/ActionsOwnerTarget dateStatusComment
Low carbohydrate diet educationCaterina, dietitian20/08/2026Planned
Reduce ratio of carbohydrates in each meal – ¼ plate carbs, ¼ plate protein, ½ plate vegetables/saladCaterina20/08/2026Planned
Substitute high GI for low GI carbohydrates where possibleCaterina20/08/2026Planned
Physical activity guidanceCaterina, exercise physiologist20/11/2026Planned
Aim for 150 mins of aerobic activity per weekCaterina20/11/2026Planned
2-3 sessions of resistance exercise per weekCaterina20/11/2026Planned
Management of impulse controlCaterina20/11/2026PlannedManage impulsivity/desire to eat when not actually hungry. Consider psychology input in future

Services and treatments

Required services and treatmentsActivityProviderComment
Dietetics serviceReferral to dietitianDietitian
Dietetics serviceDiet educationDietitian
Exercise physiology serviceReferral to exercise physiologistExercise physiologist
Exercise physiology serviceExercise regimeExercise physiologist

Completion

Consent given for sharing of information with relevant healthcare providers
Yes

Review

Appointment status
Proposed

Date
20/05/2027