1 / 21

Back to Basics, 2011 POPULATION HEALTH: Periodic Health Exam,

Back to Basics, 2011 POPULATION HEALTH: Periodic Health Exam, . Epidemiology & Community Medicine Based on slides prepared by Dr. R. Spasoff. 078-3 PERIODIC HEALTH EXAMINATION (1). Clinical Guidelines for primary and preventive care Targeted and Evidence based

anisa
Download Presentation

Back to Basics, 2011 POPULATION HEALTH: Periodic Health Exam,

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Back to Basics, 2011 POPULATION HEALTH:Periodic Health Exam, Epidemiology & Community Medicine Based on slides prepared by Dr. R. Spasoff

  2. 078-3 PERIODIC HEALTH EXAMINATION (1) • Clinical Guidelines for primary and preventive care • Targeted and Evidence based • Objectives target common conditions for each age group • Use periodic health exam for health promotion/disease prevention interventions. • Case-finding and screening for disease & risky behaviours

  3. Classification of Recommendations • A Good evidence to recommend • B Fair evidence to recommend • C Existing evidence is conflicting and does not allow to make a recommendation for or against • D Fair evidence to recommend against • E Good evidence to recommend against • I insufficient evidence to recommend

  4. Elements • Discussion • Physical exam • Tests • Therapy

  5. Gen Pop- Discussion • Dental Hygiene (community fluoridation, brushing , flossing) (A) • Noise control, hearing protection (A) • Seatbelt use (B) • Injury prevention (bicycle helmets, smoke detectors) (B) • Moderate physical activity (B)

  6. Gen Pop- Discussion • Avoid sun exposure and wear protective clothing (B) • Problem drinking screening, counselling (B) • Counselling to protect against STI’s (B) • Nutritional counselling on fat and cholesterol (B)

  7. Gen Pop- Physical Exam • Clinical breast exam women age 50-69 (A) • Blood pressure measurement (B) • BMI measurement in obese adults (B)

  8. Gen Pop- Tests • Mutiphase screening with FOB test adults>50 q1-2 yrs (A) • Sigmoidoscopy adults > 50 freq not established (B) • Bone Mineral Density (1 major or 2 minor criteria)

  9. The Canadian Task Force on Preventive Health Care concludes that there is fair evidence to recommend screening postmenopausal women to prevent fragility fractures (no or low trauma fractures) (grade B recommendation). Although there is no direct evidence that screening reduces fractures, there is good evidence that screening is effective in identifying postmenopausal women with low bone mineral density and that treating osteoporosis can reduce the risk of fractures in this population (grade A recommendation).

  10. Gen Pop- Tests • Fasting lipid profile Controversial • Fasting glucose- hypertension and hyperlipidemia • Mammography women 50-69 q1-2 yrs (A) • Sexually active women Pap Smear q1y x2, then q3y if both normal

  11. Gen Pop- Tests not Recommended • PSA still has insufficient evidence to justify screening • Syphilis tests should not be done routinely • Breast self exam (D)- fair evidence of no benefit and good evidence of harm

  12. Gen Pop- Therapy • Folic Acid supplementation women of child bearing age (A) • Pharmacologic treatment of hypertension with diastolic BP>90 mm Hg

  13. Special Pops- Smokers • Counsel on smoking cessation • Nicotine replacement therapy (A) • Referral to smoking cessation program (B) • Dietary advice on leafy green vegetables and fruits (B)

  14. Special Pops- Pediatric • Discussion • Home visits to high risk families (A) • Inquiry into developmental milestones (B) • Physical • Repeated examination of hips hearing and eyes (A) • Serial heights weights and head circumference (B) • Visual acuity testing (>2 yrs) (B)

  15. Special Pops- Pediatric • Tests • Routine hemoglobin fir high risk populations (sickle cell and thalassemia) (B) • Blood lead screening for high risk infants (B) • Therapy • Immunization

  16. Special Pops- Adolescents • Counsel on sexual activity and contraceptive methods (B) • Counsel to prevent smoking initiation (B)

  17. Perimenopausal Women • Counsel on osteporosis • Counsel on risks and benefits of hormone replacement therapy (B)

  18. Special Pops- adults>65 • Followup on caregiver concern of cognitive impairment (A) • Multidisciplinary post-fall assessment (B) • Visual acuity (Snellen) (B) • Hearing impairment (B)

  19. Special Pops- Familial • First degree relative with melanoma • Full body skin exam (B) • Familial AdenomatousPolyposis • Sigmoidoscopy and genetic testing (B) • Heridtary non-polyposis colorectal cancer • Colonoscopy (B)

  20. Special Pops- Other • Tb high risk • Mantoux testing (A) • INH chemoprophylaxis for close contacts and recent convertors (B) • STI high risk • Voluntary HIV antibody screening (A) • Gonrrhea screening (A) • Chlamydia screening (B)

More Related