Tertiary Prevention Flashcards
Use the analogy of fire to describer the 3 levels of prevention
Primary = don't play with matches Secondary = sprinklers and fire alarms Tertiary = damage control, fire hoses
Define tertiary prevention
Using measures available to reduce or limit impairments and disabilities, and to promote the patients’ adjustments to irremediable conditions
Improve function and minimise impact of established disease; prevent and delay of complications and subsequent events through management and rehab
What are the boundaries of tertiary prevention?
Lack of clear margins, chronic disease and chronic symptoms Ongoing process Multimodal, long term interventions Poor consensus in medical profession Concept of Wellness
What are the key characteristics of tertiary prevention?
Patient has established disease
Focus of intervention is either to improve function or prevent gradual decline
Intervention begins after acute disease process has run its course
Timescale for receipt of benefits
What are the types of tertiary prevention?
Clinical interventions e.g. surgery, drugs
Allied/Collaberative interventions e.g. physio, psych, OT
Societal interventions - minimising disability
List some of the impacts of chronic disease
6/10 adults report a chronic illness
80% GP consultations
60% hospital bed days
What are the 3 levels of the chronic disease pyramid?
Level 1 = supported self care
Level 2 = disease management
Level 3 = case management
What does the following graph show:
Fair Society, Healthy Lives (Marmot)
Life expectancy and disability free life expectancy are lower in poorer communities
The pension age increases from 2026-2046
In the future the proportion of people living with disablity
What are the tertiary prevention examples in the UK?
- Stroke rehabilitation
- Cardiac rehabilitation
- Renal disease
Stroke
- primary prevention =
- secondary prevention =
- tertiary prevention =
1 = smoking, alcohol 2 = TIA management, FAST, further risk reduction 3 = rehabilitation
What is involved in stroke rehabilitation?
Early Hospital - mobilisation - functional positioning - targeted AODL interventions Ongoing Community Management - early discharge - long term rehabilitation Multidisciplinary Interventions
What is the National Stroke Strategy?
- rehabilitation after stroke works.
- specialised coordinated rehabiliatio, started early after stroke and proved with sufficient intensity, reduces mortality and long-term disability
- early rehabilitation is effective when provided in specialist stroke units, or as part of properly organised early supported discharge and longer-term support in the community, according to need
What is the definition of cardiac rehabilitation?
- the coordinated sum of activities required to influence favourably the underlying cause of CVD, as well as to provide the best possible physical, mental and social conditions, so that patients may, by their own efforts, preserve or resume optimal functioning in their community and through improved health behaviour, slow or reverse progression of disease
What is involved in cardiac rehabilitation?
Education and exercise - lifestyle changes and RF modification - cardiac reconditioning - psychological techniques Secondary and Tertiary Intervention
What are the 4 phases of cardiac rehabilitation?
1 = counselling and assessment 2 = post discharge support 3 = structured exercise programme 4 = long term maintenance
