Health maintenance for adults

Health maintenance, or preventive health care, is an important component of primary care medicine. Studies show significant health benefits to routine health checks, although clinical outcomes did not change.[1]Si S, Moss JR, Sullivan TR, et al. Effectiveness of general practice-based health checks: a systematic review and meta-analysis. Br J Gen Pract. 2014 Jan;64(618):e47-53. http://bjgp.org/content/64/618/e47 http://www.ncbi.nlm.nih.gov/pubmed/24567582?tool=bestpractice.com [2]Sopcak N, Fernandes C, O'Brien MA, et al. What is a prevention visit? A qualitative study of a structured approach to prevention and screening - the BETTER WISE project. BMC Fam Pract. 2021 Jul 19;22(1):153. https://www.doi.org/10.1186/s12875-021-01503-y http://www.ncbi.nlm.nih.gov/pubmed/34275453?tool=bestpractice.com [3]Krogsbøll LT, Jørgensen KJ, Gøtzsche PC. General health checks in adults for reducing morbidity and mortality from disease. Cochrane Database Syst Rev. 2019 Jan 31;(1):CD009009. https://www.doi.org/10.1002/14651858.CD009009.pub3 http://www.ncbi.nlm.nih.gov/pubmed/30699470?tool=bestpractice.com

Cardiovascular disease (CVD), including coronary heart disease and stroke, is the leading cause of mortality in the US, followed by cancer. In 2018 in the US, 868,662 people died from CVD and 599,265 people died from cancer.[4]Virani SS, Alonso A, Aparicio HJ, et al. Heart disease and stroke statistics-2021 update: a report from the American Heart Association. Circulation. 2021 Feb 23;143(8):e254-e743. https://www.doi.org/10.1161/CIR.0000000000000950 http://www.ncbi.nlm.nih.gov/pubmed/33501848?tool=bestpractice.com [5]Centers for Disease Control and Prevention. United States Cancer Statistics: data visualizations. Cancer statistics at a glance. Jun 2021 [internet publication]. https://gis.cdc.gov/Cancer/USCS/#/AtAGlance The lifetime risk of developing cancer is around 39.5%, with the majority of newly diagnosed cases occurring in those over 55 years of age.[5]Centers for Disease Control and Prevention. United States Cancer Statistics: data visualizations. Cancer statistics at a glance. Jun 2021 [internet publication]. https://gis.cdc.gov/Cancer/USCS/#/AtAGlance [6]National Cancer Institute. Understanding cancer: cancer statistics. Sept 2020 [internet publication]. https://www.cancer.gov/about-cancer/understanding/statistics

Prevention and early detection involves periodic screening of risk factors for both CVD and cancer, and targeted lifestyle interventions for CVD prevention. Specific cancer screening recommendations for average-risk adults are available for breast, cervical, and colorectal cancer.[7]Siu AL; U.S. Preventive Services Task Force. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2016 Feb 16;164(4):279-96. https://www.doi.org/10.7326/M15-2886 http://www.ncbi.nlm.nih.gov/pubmed/26757170?tool=bestpractice.com [8]US Preventive Services Task Force., Curry SJ, Krist AH, et al. Screening for cervical cancer: US Preventive Services Task Force recommendation statement. JAMA. 2018 Aug 21;320(7):674-86. https://www.doi.org/10.1001/jama.2018.10897 http://www.ncbi.nlm.nih.gov/pubmed/30140884?tool=bestpractice.com [9]US Preventive Services Task Force., Davidson KW, Barry MJ, et al. Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. JAMA. 2021 May 18;325(19):1965-77. https://www.doi.org/10.1001/jama.2021.6238 http://www.ncbi.nlm.nih.gov/pubmed/34003218?tool=bestpractice.com Appropriate treatment can then be started as early as necessary. Patients with established CVD or high risk of CVD can reduce cardiovascular events and/or mortality with multifactorial lifestyle interventions.[10]Blokstra A, van Dis I, Verschuren WM. Efficacy of multifactorial lifestyle interventions in patients with established cardiovascular diseases and high risk groups. Eur J Cardiovasc Nurs. 2012 Mar;11(1):97-104. http://www.ncbi.nlm.nih.gov/pubmed/21130687?tool=bestpractice.com

Recommendations on preventive health care are available from the US Preventive Services Task Force. US Preventive Services Task Force recommendations Opens in new window

Advice regarding appropriate immunizations for adults is available from the Centers for Disease Control and Prevention. CDC: adult immunization schedule Opens in new window CDC: vaccine recommendations of the Advisory Committee for Immunization Practices (ACIP) Opens in new window