Clinical Prevention II: Vaccines, Chemoprophylaxis, and Behavioral Counseling

Question 1

What are the three categories of clinical prevention?

Answer 1

• Primary: Treat risk factors before disease occurs
• Secondary: Diagnose disease early before it causes symptoms
• Tertiary: Prevent complications of (and mortality from) diagnosed, clinical disease

Question 2

What are four clinical prevention interventions?

Answer 2

• Screening programs: find disease early and treat it
• Vaccination
• Chemoprophylaxis: drug therapy to prevent disease
• Behavioral counseling interventions: change habits, lifestyle

Question 3

What are two organizations involved in clinical prevention recommendations?

Answer 3

1. U.S. Preventive Services Task Force: primary care professionals, grading scale
2. Advisory Committee on Immunization Practices: recommend which vaccines should be given when, which vaccines should be paid for by government

Question 4

What are some examples of chemoprophylaxis?

Answer 4

• Vitamins (D for >64yo at incr. risk for falls)
• Aspirin for CHD
• Aspirin/NSAID for colorectal cancer
• ERMs for breast cancer
• HRT
• Topical eye antibiotics for newborns
• Folic acid for child-bearing-age females

Question 5

What are some conditions/behaviors for which behavioral counseling is recommended?

Answer 5

• Smoking
• STDs in high risk pop.
• Alcohol misuse
• Diet counseling for CRF
• Obesity
• Breastfeeding
• Skin cancer 10-24, fair skin

Question 6

What are behavior change methods?

Answer 6

• Stages of change: Prochaska, transtheoretical method
• Five A’s: Ask, Advise, Assess, Assist, and Arrange
• Motivational interviewing: Work on patients’ “ambivalence” about change, risks/benefits