Reply to this Discussion_3 references needed
One way to individualize preventive services appropriate to your patient is to ask questions related to lifestyle. Examples would be:
- Tell me what you typically eat for breakfast, lunch, dinner, and snacks.
- Tell me how you exercise, what you do and how often.
- Do you smoke? If so, what, and how much?
- Tell me about your alcohol consumption, what, how much, how often?
- When was your last physical, dental exam, eye exam?
- Are you up to date on influenza and pneumonia vaccines?
These questions alone can tell us the likelihood of the patient to develop obesity, cardiovascular disease, and diabetes. It is stated in one research study that 60% of hospital admissions are related to preventable lifestyle diseases. Specifically, 40% of all cancers, and 80% of COPD, type-2 diabetes, and cardiovascular disease can be prevented by a healthy diet, no smoking, and regular exercise. Once patients are targeted as high-risk for lifestyle illnesses, risk-management and lab testing can be ordered followed by recommendations for behavior change and medications as needed (Larsen, Sonderlund, Sondergaard, Thomsen, Halling, Hvidt, & Thilsing, 2018).
Age and gender impact the approach to delivering preventive services in different ways. First, more women visit their practitioners compared to men. In this way, men may be missing out on these services. Specifically:
- asking women over age 40 about their last breast exam/mammogram
- asking men over 50 about their last prostate exam/digital rectal exam (DRE)
- Colonoscopies are recommended for men and women starting at age 50-75 (Kurspahic-Mujcic & Mujcic, 2019, & USPSTF, 2019).
- AAA screening is recommended for men age 65-75 who have ever smoked
- HIV screening in adolescents and adults who are at risk ages 15-65
- Cervical cancer and HPB screening in women 21-65
- Osteoporosis screening in women under 65 at-risk and over age 65
- Falls prevention in people over age 65
- Skin cancer counseling ages 6 months- 24 years
- Vision screening age 3-5 years
- Stain preventive medication for those 40-75 with specific risk factors
- Hypertension screening age 18 years and up
- Specific screenings for pregnant women (USPSTF, 2019)
Developmental milestones are likely to impact the ability of people to take charge and make healthy changes. Examples of these include teens engaging in risky behaviors that would warrant the practitioner to assess safety behaviors (seat belt, motorcycle safety, alcohol use, recreational drugs, unprotected sex). Young adults aged 18-24 are the most likely to engage in physical exercise of any other age group. Obesity is likely to rise from 23% in 20-24-year olds to 35% in those in their late 20s, 30s and early 40s. Over 40- year-olds have a greater than 40% risk of obesity. Mental health should be assessed in young adults due to alcohol and drug consumption and then again in the elderly. The young adults are more prone to depression because it is a time of rapid life changes from starting or ending school, jobs, or relationships (Bonnie, 2015).
The elderly are more likely to receive immunizations such as influenza, pneumonia, and shingles (Kurspahic-Mujcic & Mujcic, 2019).
Two risk factors for health promotion include acceptability and feasibility. Will the patient accept taking control of their own health? Is the plan developed between the practitioner and patient something the patient is willing and able to do? (Larsen et al., 2018).
Asking pertinent questions mentioned above can guide us toward illness risks specific to our patients. Utilizing the USPSTF guidelines can ensure that we do not miss any important screenings.
Bonnie, R (2015) Young Adults in the 21st Century: Investing in the Health and Well-Being of Young Adults., U.S. National Library of Medicine. www.ncbi.nlm.nih.gov/books/NBK284782/.
Kurspahić-Mujčić, A., & Mujčić, A. (2019). Preventive health services utilization in patients treated by family physicians. Medicinski Glasnik, 16(2), 344–350. https://doi.org/10.17392/1027-19
Larsen, L. B., Sonderlund, A. L., Sondergaard, J., Thomsen, J. L., Halling, A., Hvidt, N. C., … Thilsing, T. (2018). Targeted prevention in primary care aimed at lifestyle-related diseases: a study protocol for a non-randomized pilot study. BMC Family Practice, 19(1), 124. https://doi.org/10.1186/s12875-018-0820-8
“USPSTF A and B Recommendations by Date.” USPSTF A and B Recommendations by Date – US Preventive Services Task Force, www.uspreventiveservicestaskforce.org/Page/Name/uspstf-a-and-b-recommendations-by-date/.