Question

Give me an example of primary, secondary, or tertiary prevention in an outpatient setting..

Answer 1

Primary prevention includes the measures taken to prevent the onset of a disease. Secondary prevention includes early identification and prevention of complications. Tertiary prevention includes symptomatic management to improve the quality of life. Let's take the case of Cerebrovascular accident. Primary prevention includes providing health education to the public regarding the risk factors of CVA. This includes teaching the importance of quitting smoking, following healthy diet will essential nutrients and avoiding intake of high fat diet,need for weight reduction and regular exercise to keep the body fit and cardiac functions normal and regular health check ups. Following these techniques can prevent the occurrence of stroke in high risk individuals. Secondary prevention includes early identification of signs of stroke like muscle weakness, difficulty speaking,loss of balance etc in an individual, identifying and treating the possible etiological factors, implementing measures to avoid the precipitating factors and treat the disease with appropriate pharmacological therapy to prevent complications. And tertiary prevention includes measures like physiotherapy to improve the muscle strength and activity level, regular follow ups to prevent further episodes of stroke and other rehabilitative therapies to maintain functional independence and improved quality of life.

Another example is of TB. Primary prevention is by BCG vaccination and environmental control measures like adequate ventillation to prevent spread. Secondary prevention involves screening at risk individuals by performing diagnostic tests like tuberculin skin test and initiating DOTS therapy. Tertiary prevention includes identifying active cases of TB, ensuring respiratory isolation to prevent spread and providing treatment with Isoniazid,Rifampicin, Ethambutol and Pyrazinamide until full recovery and negative lab tests results.