What is Preventive medicine?

 

 Diagnosis and treatment of disease (interventional medicine) will always be an important part of health care.

 

 We can expand our model of care to prevent specific diseases and drive health promotion and enhancement in our population of patients to improve Quality of Life.

 

From the Desk Of Dr. Issar 

 

PRIMARY PREVENTION 

 

Primary prevention includes action taken to avert the occurrence of disease - as a result there is no disease.

 

 

This includes lifestyle changes, weight loss and maintenance, smoking cessation, exercise, immunizations, improved sleep quality and possibly nutritional supplements. The goal here is to eliminate the causes of disease or increase resistance to the disease.

 

 

 

SECONDARY PREVENTION 

 

Secondary prevention includes actions taken to stop or delay the progression of disease.

 

The term is ususally applied to the detection of disease at its earliest stage i.e. in the asymptomatic phase of the disease, so that the treatment can be started before the irreversible pathology is present.

 

This includes early recognition of chronic diseases (e.g. hypertension, diabetes, dyslipidemia etc.) through proper screening and early treatment.

 

It could also include reversal of certain diseases if diagnosed early and treated aggresively.

 

TERTIARY PREVENTION

 

Tertiary Prevention includes the management of symptomatic disease in an effort to prevent its progression to disability or premature death.

 

The purpose here is to limit the physical and social consequences of symptomatic disease.

 

 

 

THE CHRONIC DISEASE CHALLENGE

 

Keep in mind that chronic diseases such as heart disease, metabolic syndrome, diabetes, hypertension, obesity, etc. are an epidemic in North America and to a large extent preventable.

Chronic diseases cause 70% of deaths in North America and are responsible for upto 75% of health care spending.

 

The challenge of chronic disease is that they have complex causes (not just one specific cause) and they are inexorable i.e. they worsen over time.

 

Prevention and management of chronic disease infuse a multi-pronged approach which could include - self education, drug treatment,  monitoring, lifestyle changes, referrals to dieticians etc.

 

In essence, preventive medicine is good clinical medicine that incorporates lifestyle education, dietary guidance, stress management techniques, improved sleep quality (restorative sleep) and possible nutritional supplements.

 

 

           EARLY DIAGNOSIS OF DISEASE

 

 

  • Easier to manage and cure disease if diagnosed early.

 

  • Can delay or prevent complications.

 

  • How to best use diagnostic tests which can detect problems before symptoms appear (when clinically indicated)

 

  • Obvious examples include Colonoscopy, Mammography, Pap smears, Lipid panels, Bone density etc.

 

  • Could also consider inflammatory biomarkers, 24 hour BP monitoring, homocysteine, Cologic (alternative to fecal occult blood testing), etc. on an individualized basis depending on personal risk factors (some tests are not covered by OHIP)

 

  • Important to understand the limitations of testing, e.g. how likely to miss a disease (false negative) or how likely to mis-diagnose a disease (false positive) or find some other disease which will have no consequences (incidental finding)

 

   Stay Tuned for More...........

 

 

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