Relationship between types of prevention

It can be seen that there is a clearer demarcation between primary and secondary prevention than between secondary and tertiary prevention, although the latter term is particularly useful in dealing with the elderly and the handicapped. Conceptually, curative medicine falls within the definitions of secondary and tertiary prevention while public health measures are mainly concerned with primary prevention. Prevention is really wider than medical practice but because of the success of public health practices in the past, more attention is now being focused on prevention by doctors (see Fig. 9.1). 2 As general practitioners our role in prevention is twofold:

1. First, we can recognise the preventable factors that are involved in an illness process and determine appropriate interventions.

2. Second, we can act to implement the preventive measure. In cases where the responsibility rests with the individual or the community, doctors can support prevention through education, applying political pressure or working with community agencies.

PRIMARY F^RtvtN NON

SElCQNÛAHÏ F^PitVtN ri ON

Hear hv

biological

Clinical onse:

individual

onse: o"

(no diseasei

disease

hunc:ional

KlSk Jac:ori

A by nipt or an ic signs

h.du cation Health promotion Immunisation Prophylaxis

Screening Surveillance

Diagnosis and treatment

Rehabilitation

Support Prophylaxis

Fig. 9.1 The phases of prevention in relation to the natural history of disease

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