ITEMS IN AFP WITH KEYWORD:
Health Maintenance and Counseling
The preparticipation physical evaluation (PPE) is a common primary care medical visit for young athletes. In 2019, the American Academy of Pediatrics published updated PPE recommendations. The general goals outlined in these guidelines include determining general physical and psychological health; evaluating for life-threatening or disabling conditions; and serving as an entry point into the health care system for those without a medical home or primary care physician. Consideration should be taken to address the needs and concerns of athletes who are transgender and athletes with physical and intellectual disabilities.
This article focuses on screening and counseling for health conditions that are more prevalent in, or have a unique impact on, women, transgender men, and nonbinary individuals of reproductive age. To have the greatest impact on health, physicians should focus on U.S. Preventive Services Task Force grade A and B recommendations with patients.
The American Association of Clinical Endocrinologists and the American College of Endocrinology developed a summary of known risks of using off-label hormone treatments.
Physicians have a pivotal role in preventing unintentional injuries in children. There are many evidence-based strategies that are proven to reduce morbidity and mortality from motor vehicle crashes, suffocation, strangulation, drowning, poisoning, fires, guns, falls, bicycling, and skateboarding.
Family physicians should proactively provide a patient-centered approach to sexual health that includes disease identification and treatment. Physicians and staff should be trained in identifying individual implicit bias around sexuality and adverse childhood experiences. Preventive health strategies include screening for sexually transmitted infections and diseases and offering counseling for preconception care for all patients, including gender-diverse patients.
Healthy development in adolescents occurs when risk factors are limited and when protective factors are fostered; this is encouraged when adolescents feel valued, empowered, and form healthy social connections. Threats typically result from experimentation and psychosocial stressors. Clinicians should regularly offer confidential screening and counseling because adolescents are more likely to access health care and to share sensitive information when confidentiality is assured.
Dec 1, 2019 Issue
General Health Checks in Adults for Reducing Disease-Related Morbidity and Mortality [Cochrane for Clinicians]
General health check visits have no benefit on cardiovascular morbidity or on total, cardiovascular, or cancer-related mortality. There is also no evidence that they cause patient harm.
Glycopyrronium wipes are a useful alternative for the topical treatment of hyperhidrosis of the axillae in patients nine years and older who do not respond to or tolerate nonprescription antiperspirants or topical aluminum chloride.
The goals of the health maintenance visit in school-aged children (five to 12 years) are promoting health, detecting disease, and counseling to prevent injury and future health problems. The visit should include a history (e.g., hospital care since the last visit, living situation, lifestyle habits, school performance, social determinants of health), physical examination, and appropriate screening and immunizations.
Because school-aged children (five to 12 years) are establishing patterns of behavior that may last a lifetime, it is important for physicians to counsel families on healthy lifestyle practices. Topics include a healthy diet, physical activity, screen time, sleep requirements, dental health, injury prevention, and high-risk behaviors such as tobacco, alcohol, and drug use. Sexually active adolescents should be counseled about the risk of sexually transmitted infections, with screening as indicated.