The delivery of health promotion and disease prevention services can have a wide variety of benefits for individuals, families, and society. What do we mean when we talk about “preventive services?”
What are the Preventive Services?
The classic preventive services are:
- Screening for early detection of disease
- Education and counseling of patients about behaviors that impact their health
Levels of Prevention Strategies
There are three levels of prevention strategies: primary, secondary, and tertiary.
Primary prevention involves interventions that prevent disease from occurring such as discussing with the patient strategies such as the advantages of using a helmet when riding a bicycle or motorbike, smoking assessment and counseling, or a tetanus vaccination.
Secondary prevention involves screening interventions that detect asymptomatic disease and improve outcomes, such as pap smears and a blood pressure assessment.
Tertiary prevention involves an intervention to reduce complications of established disease. Some examples are ophthalmology examinations in diabetic patients or statin use in post-myocardial patients (Essentials of Family Medicine, Sixth Edition, Lippincott. 2012. pp 29).
Jorge Curioso is a 51 year old male who comes for his annual health maintenance visit. He has a past medical history of hypertension for which he is on hydrochlorothiazide and enalapril. He drinks 2 glasses of wine on weekends. Mr. Curioso denies tobacco or recreational drug use. He has a steady sexual partner – his wife of 20 years. The patient has no known allergies. He lives in the Bronx and drives to Manhattan where he works as a zoo keeper. As part of his health care promotion, which one of the following is an example of primary prevention?
The correct answer is 1. Education to reinforce seat-belt use while driving or riding an automobile is an example of primary prevention. A fasting lipid panel serum level in a patient with no known lipid issues and a colonoscopy are examples of secondary prevention. An electrocardiogram exam to assess left ventricular hypertrophy in a known hypertension patient is an example of tertiary prevention.
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