Study reveals top 20 preventive measures

A checklist showing the most effective preventive health measures has ranked a daily dose of aspirin as the intervention with the biggest health gains.

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By  Joanne Bladd Published  June 12, 2006

A checklist showing the most effective preventive health measures, in terms of lives saved and cost-effectiveness, has ranked a daily dose of aspirin as the intervention with the biggest health gains. The study, led by former US surgeon general Dr David Satcher, compared the evidence for primary and secondary preventive services, including immunisations, screening tests and preventive medications. The results were then compiled into a top 20 list. Daily aspirin to prevent heart attacks and stroke snatched the top spot, closely followed by childhood immunisations and screening for tobacco-use screening. Of the top ten preventive measures, authors said, six are ignored by more than half of patients who’d benefit from them. The study’s authors hope the list will help clinicians decide which preventive measures should be emphasised to patients, noting that health outcomes could be improved if the most beneficial interventions were given priority. “The consequences of misplaced priorities are high,” they say. “People die and illnesses worsen because the most important preventive services do not get done.” The top ten measures are intended as a checklist for both doctors and patients, Ashley Coffield, senior analyst for the study, added. “You can use this list to start a conversation about preventive health actions.” Analysts quantified the health gains of each service in terms of longer and better quality of life. They also compared the cost-effectiveness of each intervention. The final list, shown here, is the combination of the two scores, ranking the health impact and value for money of each preventive measure. Full results are reported in the July edition of the American Journal of Preventive Medicine. To read the study, visit www.prevent.org/nccp. The health impact: the top 20 preventive measures 1. Daily aspirin for men over 40 and women over 50 2. Childhood immunisations for diphtheria, tetanus, polio etc 3. Tobacco-use screening and brief counseling 4. Routine colorectal-cancer screening for adults 50+ 5. Hypertension screening 6. Annual flu shots for adults 50+ 7. Immunisation of adults 65+ against bacteria that cause pneumonia and other related diseases 8. Screening for problem drinking 9. Vision screening for adults 65+ 10. Cervical cancer screening for sexually active women, and those over 21 11. Cholesterol screening for men 35 and older and women 35+ 12. Routine breast cancer screening for women aged 50+ and awareness discussion with women 40 to 49 13. Routine chlamydia screening for sexually-active women under 25 14. Calcium-supplement counseling for women and adolescent girls 15. Vision screening for children under 5 16. Routine counsel for women of childbearing age on the use of folic acid 17. Obesity screening for adults and diet and exercise counseling for the obese 18. Depression screening for adults 19. Hearing impairment screening for adults aged 65+ 20. Promotion of child safety measures including car seats, bicycle helmets and poison control.

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