Preventive Medicine

Disease Prevention

• Objective of Preventive Medicine is to oppose the cause of the disease and thereby the disease process
• Successful prevention depends on knowledge of causation, dynamics of transmission, identification of risk factors and risk groups, availability of prophylaxis & vaccination, and availability of treatment
• It is desirable to know the natural history of disease to initiate preventive measures

Levels of Prevention

• Primordial prevention: prevention of emergence or development of risk factors in countries or population groups where they have not yet appeared
• Primary prevention: action taken prior to the onset of disease
• Secondary prevention: action which stops the progress of a disease at its early stage and prevents complications
• Tertiary prevention: measures to reduce or limit impairments and disabilities, minimize suffering, and promote patients' adjustment to permanent conditions

Primary Prevention

• Works with people who have at least one risk factor for developing disease
• Approaches for primary prevention of chronic diseases:
  • Population (mass) strategy
  • High-risk strategy

Secondary Prevention

• More expensive, less effective, and occurs after the patient has already been subject to mental and physical pain
• Methods of intervention: medical treatment, health education, and lifestyle changes

Tertiary Prevention

• All measures to reduce or limit impairments and disabilities, minimize suffering, and promote patients' adjustment to permanent conditions

Modes of Intervention

• Intervention is an attempt to interrupt the usual sequence in the development of disease in man
• Five modes of intervention:
  • Health promotion
  • Specific protection
  • Early diagnosis and treatment
  • Disability limitation
  • Rehabilitation

Health Promotion

• Enabling people to increase control over the determinants of health and thereby improve their health
• Includes health education, nutritional intervention, and lifestyle and behavioral change

Specific Protection

• Immunization, use of specific nutrients, chemoprophylaxis, protection against occupational hazards, protection against accidents, and avoidance of allergens

Early Diagnosis and Treatment

• Earlier a disease is diagnosed and treated, the better it is from the point of view of prognosis

Disability Limitation

• Concept of disability: disease → impairment → disability → handicap
• Example: an accident → loss of foot → cannot walk → unemployed

Rehabilitation

• Combined and coordinated use of medical, social, educational, and vocational measures for training and retraining the individual to the highest possible level of functional ability