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COVID-19 and Global Public Goods
Published in Rui Nunes, Healthcare as a Universal Human Right, 2022
To promote health, prevent disease, and restore health, a distinction is classically made between primordial, primary, secondary, and tertiary prevention. On the one hand, interventions with broad social and economic reach that, by themselves, affect the health of a population. Policies promoting healthy lifestyles, such as prevention of smoking, drug addiction, alcoholism, or the use of masks and social etiquette, fall within this concept of primordial prevention. On the other hand, primary prevention targets individuals or the general population and aims to reduce the incidence of the disease. COVID-19 vaccination or health education are concrete examples of this type of social prevention. Secondary prevention uses, for example, screening for a disease (COVID-19 mass testing) to detect the disease early, with important impacts on its prevalence and associated morbidity and mortality. Tertiary prevention aims to limit the development of a disease, prevent or minimize its complications, and promote family, social, and even labor reintegration. Quaternary prevention aims to reduce the risk of iatrogenic and inappropriate use of medications. It is a model in which 4P medicine (predictive, preventive, participated, and personalized) combines the different existing technological resources to obtain the best health outcomes. COVID-19 is a good example of how 4P medicine can be socially and individually useful.
Education and professional development
Published in Michael Kidd, Cynthia Haq, Jan De Maeseneer, Jeffrey Markuns, Hernan Montenegro, Waris Qidwai, Igor Svab, Wim Van Lerberghe, Tiago Villanueva, Charles Boelen, Cynthia Haq, Vincent Hunt, Marc Rivo, Edward Shahady, Margaret Chan, The Contribution of Family Medicine to Improving Health Systems, 2020
Michael Kidd, Cynthia Haq, Jan De Maeseneer, Jeffrey Markuns, Hernan Montenegro, Waris Qidwai, Igor Svab, Wim Van Lerberghe, Tiago Villanueva, Charles Boelen, Cynthia Haq, Vincent Hunt, Marc Rivo, Edward Shahady, Margaret Chan
In addition, the concept of quaternary prevention has been introduced, although there are competing definitions for the term.57 While one definition tends to refer to the restoration of function in the severely ill, WONCA has also endorsed an alternative definition as the action taken to identify the risk of overmedicalization and protect a patient from additional medical invasions or interventions to the degree ethically acceptable.56
On Identifying and Categorizing Health and Medical Care
Published in John B. Davis, Robert McMaster, Health Care Economics, 2017
John B. Davis, Robert McMaster
Quaternary prevention, if defined as seeking to obviate iatrogenic problems, is controversial in that it can be conceived as a critique of the biomedical paradigm, and potentially the prescribing behavior of physicians and the influences on this. As discussed in Chapter 2, the biomedical orientation has been criticized as reductionist and exclusionist (Engel, 1977). By framing and constructing disease in almost exclusively biomedical terms, clinicians’ mode of thought becomes focused on establishing specific medical treatment protocols in curing particular discrete instances of clinically defined disease (see section 3.4.2 which follows). Reflecting this concern, Doyal and Gough (1991: 202) have argued:The more conservative medical research is, the more it will restrict itself to the conceptualization and treatment of illness only in specific aetiological terms … This can lead to health resources being spent on expensive diagnostic and curative technologies rather than on preventive measures which are more cost effective.
Obesity in midlife: lifestyle and dietary strategies
Published in Climacteric, 2020
In this ‘complication-centric’ framework, lifestyle medicine is the first step and offers interventions at all preventive stages: primordial (decreasing disease risk by preventing an obesogenic environment on a population level), primary (decreasing disease in at-risk patients), secondary (decreasing complications in patients with early disease), and tertiary (decreasing the morbidity and mortality in patients with complications and/or late disease)19. Quaternary prevention is a new patient-centered paradigm that helps general practitioners to avoid stigmatization, overmedicalization, overdiagnosis, and overtreatment of obesity which may cause ‘more harm than good’20,21.
Secondary and tertiary preventions of thyroid disease
Published in Endocrine Research, 2018
Fereidoun Azizi, Ladan Mehran, Farhad Hosseinpanah, Hossein Delshad, Atieh Amouzegar
Secondary prevention is the prevention of progression of latent or mild disease to more advanced stages. Tertiary prevention is the optimizing of medical care and management for improvement of already established disease and avoidance of complications and disabilities.2 A recent addition to the lexicon of prevention is ‘‘quaternary prevention.’’ The world organization of family physicians (WONCA) defined quaternary prevention as ‘‘an action taken to identify a patient at risk of over-medicalization, to protect from new medical invasion, and to suggest interventions which are ethically acceptable.’’3