Adult Female Preventive Care Objectives and References

Periodic/preventative health care involves relating to an asymptomatic patient for the purpose of case finding and screening for undetected disease and higher risk behavior. It is also an opportunity for health promotion and disease prevention.  The elements of the PHE can be delivered by dedicated planned visits or opportunistically in the context of other health care visits. 

The decision to include or exclude a medical condition in the PHE should be based on the burden of suffering caused by the condition, the quality of the screening, and effectiveness of the intervention.

Objectives:

By the end of Family Medicine Clerkship, students will be able to:

                1.     Conduct a patient interview so as to identify any significant age-, sex-, context-specific risk factors for health conditions.

a.    Examples include exercise, diet, substance use, immunizations, falls

                2.     Conduct an age-, sex-, and context-specific evidence-informed physical exam.

a.    Examples include blood pressure, weight, waist circumference

                3.     Discuss pertinent screening tests and explain their purposes & limitations.

a.    Examples include Pap testing, Mammography, Colorectal cancer screening, bone mineral density, diabetes and hyperlidipemia screening

                4.     Counsel patients on relevant health promotion/ disease prevention strategies.

a.    Examples include immunizations, exercise, diet, calcium/Vitamin D, smoking cessation

References:

Recommended Resources Addressing the Objectives

Female Preventive Care Checklist Form (2 pages)
Objectives covered: All
        http://www.cfpc.ca/uploadedFiles/Health_Policy/_PDFs/PreventiveCareChecklistFemaleEnglish2011.pdf
        Dubey V, Mathew R, Iglar K, Duerksen A. Preventive Care Checklist Form: For average-risk, routine, female health assessments. 2010; Available at:                    http://www.cfpc.ca/uploadedFiles/Health_Policy/_PDFs/PreventiveCareChecklistFemaleEnglish2011.pdf. Accessed Aug/01, 2014.
        No PMID

Explanations for the Preventive Care Checklist Form (4 pages)
Objectives covered: All
        http://www.cfpc.ca/uploadedFiles/Health_Policy/_PDFs/PreventiveCareChecklistExplanation2011.pdf
        Dubey V, Mathew R, Iglar K, Duerksen A. Explanations for the Preventive Care Checklist Form. 2010; Available at:                                                                      http://www.cfpc.ca/uploadedFiles/Health_Policy/_PDFs/PreventiveCareChecklistExplanation2011.pdf. Accessed Aug/01, 2014.
        No PMID

Preventive Activities - Adults (1 page)
Objectives covered: 1, 4
        https://www.ucalgary.ca/familymedicine/system/files/preventive_activities_feb_2014.pdf
        Dickinson J. Preventive activities - Adults. 2014; Available at: 
        https://www-ucalgary-ca.ezproxy.lib.ucalgary.ca/familymedicine/system/files/preventive_activities_feb_2014.pdf. Accessed Aug/01, 2014.
        No PMID

General Health Checks in Adults for Reducing Morbidity and Mortality From Disease (Don't be overzealous with the "annual physical")
Objectives covered: 2,3,4 
        http://jama.jamanetwork.com/article.aspx?articleid=1697948
        Krogsboll LT, Jorgensen KJ, Gotzsche PC. General health checks in adults for reducing morbidity and mortality from disease. JAMA 2013 Jun                                19;309(23):2489-2490.
        PMID:23780462

Additional resources

2011 Canadian Guidelines for Primary Care of Adults with Developmental Disabilities
        http://www.cfp.ca/content/57/5/541.full

Screening guidelines for cervical cancer, breast cancer, and colorectal cancer:
        http://canadiantaskforce.ca/ctfphc-guidelines/overview/

How to perform a pelvic examination
        http://thehub.utoronto.ca/family/wp-content/uploads/2013/07/Performing-a-Pelvic-Examination.pdf

An Update on Breast Cancer Screening and Prevention (17 pages - if you want more information)
        http://www.ncbi.nlm.nih.gov/pubmed/24830609
        de la Cruz MS, Sarfaty M, Wender RC. An update on breast cancer screening and prevention. Prim Care 2014 Jun;41(2):283-306.
        PMID:24830609

Review of bisphosphonate use for osteoporosis prevention (10 pages):
        http://www.cfp.ca/content/60/4/324.full?sid=daa9d685-ce1d-4f4e-8852-a82c6c7c6000
        Brown JP, Morin S, Leslie W, Papaioannou A, Cheung AM, Davison KS, et al. Bisphosphonates for treatment of osteoporosis: expected benefits, potential            harms, and drug holidays. Can Fam Physician 2014 Apr;60(4):324-333.
        PMID:24733321

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