Download Aging Q3 Screening and Prevention Detailing Sheet - 238

Logo
Aging Q3
Screening and Prevention
ACOVE 6
Out Patient
Prevention strategies can be classified as primary (preventing the onset of disease), secondary (finding disease in early and
curable stages), and tertiary (prevention of further morbidity in established disease). Elderly patients continue to benefit from
the primary strategies of vaccination and counseling, but benefit from secondary and tertiary modalities depends on life
expectancy and patient acceptance. (Covinsky, 2001)
PRIMARY PREVENTION
Physician reminders and health maintenance systems increase the provision of preventive services.
Recommended vaccinations in patient
over 65 years of age
Vaccine
Intervals
dT
Every 10 years
(replace one
booster with Tdap if
contact with child
<12 months)
Pneumovax
Once after age 65.
If < 65 and 5 years
have passed –
revaccinate once
Influenza
Yearly during flu
season
Zoster
Once after age 60
www.cdc.gov accessed 8/9/12
Contraindications and Precautions
Contraindications
• Severe allergic reaction (e.g., anaphylaxis) after a previous vaccine dose or to a vaccine
component
For Tdap only: Encephalopathy (e.g., coma, decreased level of consciousness, or prolonged
seizures), not attributable to another identifiable cause, within 7 days of administration of
previous dose of DTP, DTaP, or Tdap.
Precautions
• Moderate or severe acute illness with or without fever
• Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose of tetanus toxoidcontaining vaccine
• History of Arthus-type hypersensitivity reaction following a previous dose of tetanus and/or
diphtheria toxoid-containing vaccine: defer vaccination until at least 10 years have elapsedsince
the previous dose
For Tdap only: Progressive or unstable neurological disorder, uncontrolled seizures, or
progressive encephalopathy until a treatment regimen has been established and the condition
has stabilized.
Contraindication
• Severe allergic reaction (e.g., anaphylaxis) after a previous vaccine dose or to a vaccine
component.
Precautions
• Moderate or severe acute illness with or without fever
Contraindication
• Severe allergic reaction (e.g., anaphylaxis) after a previous vaccine dose or to a vaccine
component, including egg protein
Precautions
• Moderate or severe acute illness with or without fever
• History of GBS within 6 wks of previous influenza vaccine
Contraindication
•
Severe allergic reaction (e.g., anaphylaxis) to a vaccine component
•
Known severe immunodeficiency (e.g., from hematologic and solid tumors, receipt of
chemotherapy, or long-term immunosuppressive therapy4 or patients with HIV infection
who are severely immunocompromised – CD4<200).
Precautions
•
Moderate or severe acute illness with or without fever.
•
Receipt of specific antivirals (i.e., acyclovir, famciclovir, or valacyclovir) 24 hours before
vaccination; if possible, avoid use of these antiviral drugs for 14 days after vaccination.
rev. 8/10/12
Practice Partner Health Maintenance Templates
Templates can be customized by adding medications and disease states. You can enter codes for “Done
Elsewhere” and “Refused”. ASK YOUR PRECEPTOR TODAY!
Exercise Counseling
Elderly patients can build muscle mass, increase endurance, prevent falls, reduce depression and increase functional
independence through exercise.
Most patients should aim for aerobic exercise 5 days a week and resistance training 2-3 days per week – start
with walking. Exercise prescriptions improve compliance with recommendations. Assess exercise readiness
and give patients a prescription.
Exercise Readiness Assessment
1. Does the patient currently exercise?
2. Is the patient healthy enough for independent exercise (no balance
problems/unstable coronary symptoms, etc.)?
3. Determine “stage of change” and which action to take
4. Give an exercise prescription and referral form based on the chart.
www.exerciseismedicine.org