Prevention Flashcards
Primary Prevention
to prevent a disease becoming established. It aims to reduce or eliminate exposures and behaviours that are known to increase an individual’s risk of developing a disease. It can be aimed at individual behaviour change or as a population approach (e.g. immunisations or high risk approaches such as weight management).
Secondary prevention
to detect early disease and slow down or halt the progress of the disease.
Tertiary prevention
Once disease is established, detectable and symptomatic, tertiary prevention aims to reduce the complications or severity of disease by offering appropriate treatments or interventions.
Prevention paradox
The prevention paradox states that a larger number of people at small risk of disease may contribute to more cases of that disease than a smaller number of people who are individually at greater risk.
High risk
- Target highest risk individuals
- Aim to reduce risk to below set limit
- Accepted by society - treat those outside “normal levels”
Population approach
- Target all individuals
- Aim to reduce the risk for each individual
- Recognises that the low risk majority may contribute most cases
- Concerns over treating the well and the “nanny state”
Implications of High risk approach
favours those who are more affluent and better educated. They are:
• More likely to engage with health services
• More likely to comply with treatments
• More likely to have the necessary means to change their lifestyle
Implications of population approach
generally reduces social inequalities
CHD
Cardiovascular disease accounts for 40% of deaths in the UK (1 in 5 men and 1 in 8 women). Rates are decreasing due to lifestyle changes and effective treatments.
Primary prevention in CHD
involves lifestyle changes and prevention and management of the related conditions of hypertension, hypercholesterolaemia and diabetes.
Lifestyle changes to prevent CHD (and hypertension, hypercholesterolaemia and diabetes)
SNAP
• Smoking (taxation, no public places, cessation services, health warnings, tobacco control)
• Nutrition (recommendations e.g. 5 a day, food standards/regulation/labelling and food in schools)
• Alcohol (know your limits, taxation, alcohol pricing and regulation)
• Physical activity (At least 5 times a week, PE in schools etc)
Secondary prevention in CHD
Actions include:
• Primary care CHD registers
• Medical management: Aspirin, B-blockers, ACE inhibitors, statins
• Phase 4 cardiac rehabilitation
Cardiac rehabilitation
- Phase 1 – in hospital
- Phase 1 – Early post discharge
- Phase 3 – 4 – 16 weeks
- Phase 4 – long term maintenance of lifestyle change (SNAP)
Changes in risk factors and treatments of CHD
- Obesity and diabetes have risen and physical activity is decreasing. These increase the risk of CHD.
- Smoking, cholesterol, blood pressure levels, deprivation and other factors have fallen. This decreases the risk of CHD.
- Treatments for CHD are improving.
Risk factors of CHD - two categories
potentially modifiable and unmodifiable
