• Clinical science

Preventive medicine


Preventive medicine aims to reduce risks factors that contribute to disease development and progression. Such practices are divided into primary (e.g., immunization), secondary (e.g., screening tests), and tertiary prevention (e.g., medical or surgical therapy, rehabilitation). The paradox of prevention is that the measures that benefit the population as a whole rarely benefit the individual.

See related article Epidemiology.

Primary prevention


  • Prevent the onset of specific diseases via risk reduction by altering behaviors or exposures that can lead to disease, or by enhancing resistance to the effects of exposure to a disease agent.
  • Primarily decrease the incidence, and in turn, decrease the prevalence of disease.


Secondary prevention


  • Early detection of disease in asymptomatic patients to promote early intervention, and to prevent further progression and complications from the disease.
  • Consists of a 2-step process: screening test to identify disease and a follow-up for management of the disease.


Secondary prevention testing measures are not intended to be diagnostic!


Tertiary prevention


  • Optimize care of patients with an established disease to improve functionality and prevent complications.
  • Lower the risk of relapse.


  • Blood pressure management
  • Diabetes management
  • Lifestyle modification

Medication adherence

  • Definition: The extent to which an individual follows the prescribed medication and medical advice
  • Common reasons
    • Financial burden
    • Lack of motivation
    • Lack of understanding of the disease
    • Polypharmacy, multiple comorbidities, complex treatment regimen
    • Personal health beliefs
    • Lack of understanding the instructions provided by the physician
  • Strategies to encourage adherence:
    • Identify potential barriers
    • Open communication
    • Use a patient-centered approach
    • Provide patient education
      • Provide written instructions
      • Discuss medication side effects and consequences
    • Reminder system
      • Frequent follow-up visits
      • Call centers
      • Email reminder programs
      • Electronic alerts
      • Nurse coaches