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17-06-2012 | Article

Many US adults do not get basic preventive health services


Full report

MedWire News: If an ounce of prevention is worth a pound of cure, US healthcare needs to place more weight on preventive measures, suggest results of a report from the Centers for Disease Control and Prevention (CDC).

A review of clinical preventive services in the USA from 2007 through 2010 showed that less than half (46.9%) of all patients with ischemic vascular disease were prescribed aspirin or another antiplatelet therapy, only 44% of adults with diagnosed hypertension had it under control, and only 68% had cholesterol levels checked at any time during the preceding five years, according to the report, published as a supplement to the Morbidity and Mortality Weekly Report.

"Improved clinical management of the ABCS ‑ aspirin, blood pressure control, cholesterol management, and smoking cessation ‑ can significantly reduce the risk for cardiovascular disease, our nation's leading killer, and could save approximately 100,000 lives each year," writes CDC Director Thomas Frieden in a foreword to the report.

The authors focus on specific interventions that are known to prevent disease, including blood pressure control, screening for lipid disorders, glucose control among people diagnosed with diabetes, screening for tobacco use and smoking cessation programs, screening for breast and colorectal cancers, HIV awareness, and influenza vaccinations for adults.

Other key findings included:

  • More than one-third (36%) of US citizens have elevated low-density lipoprotein (LDL) cholesterol, but only 31.6% of this group had their levels under control.
  • Only 20.9% of patients who screened positive for tobacco used received cessation counseling, and 37.3% of outpatient visits had no documentation about whether the patient used tobacco.
  • Of adults diagnosed with diabetes, 12.9% had poor glycemic control, defined as a hemoglobin A1c level higher than 9%.
  • Approximately 20% of women from the ages of 50 through 74 years had not had a mammogram during the preceding ten years.
  • Approximately one-third of adults from the ages of 50 through 75 years were not up to date with colorectal cancer screening.
  • Approximately 20% of the estimated 1.1 million people with HIV infections had not been diagnosed.
  • Only 28% of adults under age 65 years were vaccinated against influenza.

"Recent changes in the US healthcare system provide opportunities to expand use of preventive services. The Patient Protection and Affordable Care Act of 2010 as amended by the Healthcare and Education Reconciliation Act of 2010 (referred to collectively as the Affordable Care Act) emphasizes both population-based prevention and individual clinical preventive services. Implementation of the Affordable Care Act has the potential to lead to substantial reductions in morbidity, premature mortality, and associated health spending by expanding access to health insurance and increasing use of preventive services," the authors write.

By Neil Osterweil