Quaternary prevention: Need of the hour

Pandve, Harshal T

doi:10.4103/2249-4863.148090

Cited by 33 publications

(23 citation statements)

References 2 publications

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“…Interventions which address paediatric intussusception through “primordial”/primary and secondary prevention would be of most benefit in this situation. “Primordial” and primary prevention seek to address potential risk factors and risk behaviors for a disease in the wider community [ 6 ]. Hand washing campaigns in hospitals have been shown to reduce nosocomial rota-virus infection, an etiological agent of intussusception, within these facilities [ 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

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Geospatial distribution of severe paediatric intussusception in KwaZulu-Natal province, South Africa

Moodley¹,

Moodley²,

Mashele³

et al. 2020

Pan Afr Med J

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Introduction intussusception in South African (SA) children is often severe. A proportion of cases require management at quaternary hospitals which are a scare resource in SA. A geospatial investigation of severe paediatric intussusception (SPI) in the KwaZulu-Natal (KZN) province of SA would assist with identifying regions which should be targeted for preventative interventions. This could reduce resource utilisation for this condition at quaternary hospitals. The objective of this study was to determine the geospatial distribution of SPI in KZN. Methods this was a retrospective analysis of data for patients with SPI who were admitted to a quaternary hospital in KZN over an 11-year period. Data related to patient demographics, duration of hospitalization, surgical intervention, inpatient mortality and residential postal code were extracted from the electronic hospital admissions system. Each residential postal code was linked to a corresponding KZN district municipality. Descriptive statistical methods were used to determine the distribution of various characteristics in the study sample. Semi-quantitative geospatial analysis was used to determine the distribution of patients with SPI in each KZN district municipality. Results the study sample consisted of 182 patients with SPI. Most patients were <1 year old (83.5%), male (51.1%) and black African (87.9%). All patients underwent surgical intervention. Inpatient mortality was 2.7%. The majority of patients in the study sample resided in the eThekwini and King Cetshwayo district municipalities (51.1% and 14.8%, respectively). Conclusion preventative interventions for SPI should be considered for rollout in the eThekwini and King Cetshwayo district municipalities of KZN, SA.

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Section: Discussionmentioning

confidence: 99%

“…The early diagnosis of disease forms the basis of secondary prevention. Early diagnosis of disease is often coupled with early treatment, and this reduces the possibility of the disease advancing in severity [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Geospatial distribution of severe paediatric intussusception in KwaZulu-Natal province, South Africa

Moodley¹,

Moodley²,

Mashele³

et al. 2020

Pan Afr Med J

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“…How can a doctor be considered of having a good practice when he demands intensive laboratory tests/examinations without the required justifications that these interventions would necessarily lead to more benefit than harm? 15 This clinical practice could equally be recognized at all levels of Vietnam's national healthcare system, 10 which might be explained by the international trend of hospital-centrism described in the WHO 2008 report. 17…”

Section: Interpretation Of Findingsmentioning

confidence: 99%

“…Currently, P4 concept is gaining its momentum in medical professional around the world, 8,14,15 and has just been recently introduced in Vietnam. For instance, during the six years of undergraduate medical programme in Vietnam, students have a disproportionate medical and clinical formation based on focal-specialists (consultants) and a hospital type of care environment.…”

Section: The Importance Of the Introduction Of P4 In Vietnamese Medicmentioning

confidence: 99%

Impact of quaternary prevention as a brief intervention in medical students’ clinical decisions: experience from Vietnam

Tran

2015

Rev Bras Med Fam Comunidade

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Objective: to evaluate undergraduate medical students’ clinical decision-making process after a brief intervention lecture on quaternary prevention (P4). Methods: quantitative self-controlled intervention study carried out with fifth-year medical students of Pham Ngoc Thach University, Hochiminhcity, Vietnam. The medical students were asked to list their eventual interventions based on three different simulated clinical scenarios. The survey was conducted before and after the intervention. Student’s propositions were classified into one of the four groups of prevention, according to Jamoulle’s model. Results: 115 students participated, resulting in 211 answered sheets. The interventions proposed by the students were mostly centered on prevention groups 1, 2 and 3; the three clinical scenarios partially explained student’s intentions of counseling, screening and palliative care. Comparing the data of second phase survey, the intervention was associated with changes in students’ aptitude on clinical decision-making, which was especially more important for prevention group 1 (OR = 7.5) and prevention group 4 (OR = 30.05). There was no statistically significant difference in changing students’ decision for prevention group 2 (OR = 0.95 p = 0.466) and prevention group 3 (OR = 2.29 p = 0.932). Conclusion: introducing quaternary prevention to the undergraduate medical course can help to steer clinical decisions toward primary prevention and to avoid inappropriate medical interventions.

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“…Quaternary prevention is defined as “the action taken to identify people at risk of over-medicalization, to protect them from new medical invasion, and to suggest them interventions ethically acceptable.” The concept of quaternary prevention makes it easier to “identify the patients at risk of over-medicalization.” Therefore, the monitoring of self-medication and identifying its determinants can be considered as important activities in the field of quaternary prevention. 25…”

Section: Introductionmentioning

confidence: 99%

Demographic determinants of self-medication in the population covered by health centers in Tabriz

Shaamekhi

Jafarabadi

Alizadeh

2019

Health Promot Perspect

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Background: Self-medication is the choice and use of medications by people to treat a selfdiagnosed illness or symptom. The aim of this study was to search the relationship between a number of socio-demographic conditions and self-medication in the population covered by health complexes in Tabriz, Iran. Methods: This study was a cross-sectional descriptive-analytic study and was carried out on the population covered by health complexes in Tabriz. Participants were recruited by a multi-stage sampling method. A total of 1000 participants were included in the study. Data collection was done using a researcher-created questionnaire. Data were analyzed using chi-square test and logistic regression. Results: The incidence of self-medication was 70.9% for participants who reported illness in the last month. The chance of self-medication was higher in young (P = 0.007) and middleaged (P = 0.012) groups, and housewives (P = 0.048); and was lower among participants who were not literate (P = 0.047). There was no significant relationship between gender and selfmedication (P = 0.553). The high cost of visits was mentioned as a reason for self-medication. The most frequently mentioned drugs used in self-medication were analgesics, cold medicines, and antibiotics, respectively. More frequent reasons for self-medication were the previous experience of the disease, the assumption that the ailment was not important, and the high cost of visits, respectively. Conclusion: The prevalence of self-medication in this study was high. Considering the results, education in the community, financial support, and monitoring the delivery of drugs can play an important role in improving the pattern of drug use.

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Quaternary prevention: Need of the hour

Abstract: Prevention is primarily categorized as Primordial, Primary, Secondary and Tertiary. Now the concept of “Quaternary Prevention” is also introduced. This editorial article discusses need of Quaternary prevention in current scenario of clinical practice.

Cited by 33 publications

References 2 publications

Geospatial distribution of severe paediatric intussusception in KwaZulu-Natal province, South Africa

Geospatial distribution of severe paediatric intussusception in KwaZulu-Natal province, South Africa

Impact of quaternary prevention as a brief intervention in medical students’ clinical decisions: experience from Vietnam

Demographic determinants of self-medication in the population covered by health centers in Tabriz

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