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Top prevention priorities for patients and doctors

Focusing on a handful of top prevention priorities can add years to the life expectancy for everyone in the family, experts advise.

“Patients must be prepared to engage in preventive services during office visits when time permits,” Dr. Michael V. Maciosek of Healthners Institute, Minneapolis, Minnesota told Reuters Health. “They need to be willing to make a commitment to follow-up with preventive care discussions with their doctor due to the schedule of testing as needed, filling and taking prescribed medications, or the adoption of healthy behavior.”

Working with the National Commission for the Prevention, Maciosek and a panel of doctors, insurance, plan leaders, employers, representatives of the government and the academic world have joined forces to create a priority list of 28 preventive services that are both life-saving and cost-effective.

Having children recommended vaccines, counseling to discourage the young from the first, tobacco use, and guidance of adults to stop the use of tobacco reaches the highest possible life-extending and cost-effectiveness scores, the panel reported in Annals of Family Medicine.

Screening for alcohol abuse (with a brief intervention if necessary), and guidance on use of low-dose aspirin also has a long life and saving of money.

Other highly valued services included screening for high blood pressure, high cholesterol, cervical cancer and colorectal cancer, and sexually transmitted infections (STIS).

“All services on the list are evidence-based and most offer a good value in terms of the health of the benefits they offer in comparison with the costs, even if they don’t save money,” Maciosek said in an e-mail.

“Doctors, patients, clinic policy, support systems, can make best use of the available time and resources for the approach of the highest value preventive services before you to other evidence-based services,” he added.

Dr. George Isham of Healthners Institute, who wrote the editorial in connection with this report, told Reuters Health via e-mail, “Not all recommended services have the same positive preventive effect. Some are far more valuable in securing a longer and disease-free life than others . . . . (Patients) should pay particular attention to the top recommendations, and to ensure that their doctors will do everything they can to see that our top recommendations are referred to as ” services.”

“The top recommendations should be the highest priorities for their personal wellness and health improvement programs,” Isham said.

He added that if the full coverage of preventive services is eliminated by a repeal of the Affordable Care Act, people “should look to their employers for information about these topics by means of health at the workplace improvement of the programs . . . They should advocate for the employer, coverage for these services.”

For anyone who is without insurance or in a new-designed plan without full coverage of preventive services, “knowing what has the greatest potential impact under the recommended preventive services that may be useful in making decisions about which services are most important to buy, given the very limited resources,” Isham said.

Dr. Kirsten Bibbins-Domingo, chairman of the government-backed U. S. Preventive Services Task Force (USPSTF), told Reuters Health by email, “This study confirms the importance that the clinical prevention plays in improving the quality and duration of life for patients in the US. the U. S. Preventive Services Task Force . . . welcome(s) studies, such as this which draw attention to the importance of prevention and hope that they increase awareness among patients, doctors and policy makers about which preventive services are beneficial, so that the patients can continue to receive the care they need to stay healthy.”

Bibbins-Domingo noted that while the cost-effectiveness is heavily factored into the results of this study, the USPSTF “does not take into account the issuance costs of the recommendations. By not taking into account the costs, the Task Force maintains a clear focus on the science of clinical effectiveness (aka ‘what works’) of each preventive service reviews.”

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