Health Promotion and Disease Prevention in PHC

What is health promotion?

Enabling people to increase control over their health through social and environmental interventions that address root causes of ill health

What is disease prevention?

Specific interventions (population or individual) aimed at primary or secondary prevention to minimise disease progression and risk factors.

Define primary prevention.

ction to avoid or remove the cause of a health problem before it arises (e.g., immunisation, lifestyle advice).

Define secondary prevention.

Early detection and treatment to reduce severity or spread (e.g., screening).

Define tertiary prevention.

Reducing complications or functional impairment of established disease (e.g., preventing diabetic complications).

Define quaternary prevention.

Identifying patients at risk of overmedicalisation and protecting them from unnecessary interventions.

Why is general practice an ideal setting for health promotion?

Population coverage, accessibility, acceptability, frequent contacts, patients focused on health during visit

Why might general practice NOT be ideal for health promotion?

Reactive rather than preventative, individual rather than population focus, disease‑focused, time constraints.

What is the goal of Healthy Ireland?

Prevent chronic disease by promoting healthy behaviours and creating healthier environments.

Name four Healthy Ireland programme areas.

Tobacco Free Ireland; Mental Health & Wellbeing; Sexual Health & Crisis Pregnancy; Healthy Eating & Active Living.

What is Sláintecare Healthy Communities?

Local area initiatives targeting communities with concentrated health risks, delivered through partnerships (HSE, local authorities, community groups).

examples of Sláintecare Healthy Communities initiatives.

Stop Smoking Advisors, QUIT services, parent programmes, Healthy Food Made Easy, Social Prescribing, MECC, integrated alcohol services.

Examples of primary prevention in GP.

Behavioural risk information, opportunistic case finding, annual chronic disease prevention programme, Smart Diabetes Program.

What is the aim of the Opportunistic Case Finding Programme?

Identify patients at high risk of CVD or diabetes or those with undiagnosed disease during routine GP visits.

How many patients were identified in the first two years?

16,000 with pre‑diabetes; 2,800 newly diagnosed with type 2 diabetes.

Who is eligible for the HSE prevention programme?

Adults ≥45 with medical/GP visit card; those at risk of heart disease/diabetes; adults with gestational diabetes or pre‑eclampsia.

What does the prevention programme include?

Annual GP + nurse review, medication review, risk factor plan, health promotion advice, treatment, referrals

What does the Irish Diabetes Prevention Programme offer?

A 12‑month group programme (online or in‑person) via GP referral.

What are the components of the Irish DPP?

Eating for Health, Movement for Health, Weight for Health, Change for Health, Understanding Risk.

What did the NEJM 2001 Finnish Diabetes Prevention Study show?

Lifestyle changes reduced progression to T2D by ~58% in people with impaired glucose tolerance.

What did the US DPP (2002) show?

Lifestyle intervention reduced T2D incidence by 58%; metformin by 31%.

Who is eligible for the structured chronic disease treatment programme?

Adults >18 with T2D, asthma/COPD, CVD, heart failure, AF, stroke/TIA.

What does the structured programme focus on?

Managing conditions in GP, avoiding hospital stays, early detection of complications, self‑management education.

What is included in the twice‑yearly reviews?

Nurse + GP visit, education, preventative care, medication review, physical exam, investigations (e.g., HbA1c), individual care plan.

What is the purpose of ECC?

Increase community healthcare capacity, reduce hospital pressure, support older people and those with chronic disease.

what is Diabetic RetinaScreen?

National programme detecting early diabetic retinopathy via retinal photography.

Who is eligible for RetinaScreen?

Anyone ≥12 years with diabetes, annually.

Who analyses the images?

Ophthalmologists or optometrists.