Quaternary prevention

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Quaternary prevention
Purposeidentify patients at risk of overmedication

Quaternary prevention means avoiding unnecessary medical interventions. They are the actions taken to identify an individual at risk of overmedicalisation, to protect them from new medical invasion, and to suggest interventions which are ethically acceptable.[1][2] The term was coined by the Belgian general practitioner Marc Jamoulle,[3]

Quaternary prevention is the set of activities to mitigate or avoid the consequences of unnecessary or excessive intervention of the health system,[4] i.e.iatrogenic damage.

Definition

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The Wonca International Dictionary for General/Family Practice defines it as "action taken to identify patient at risk of overmedicalisation, to protect him from new medical invasion, and to suggest to him interventions, which are ethically acceptable".[5]

Alternatively, quaternary prevention has been defined as an "action taken to protect individuals from medical interventions that are likely to cause more harm than good."[6]

Per Jamoulle

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Jamoulle divided medical situations into four quadrants based on if the patient was experiencing illness (i.e. if the patient experienced subjective poor health) [citation needed]and if a health care provider had identified disease (constructed based on diagnostic criteria), with a different type of prevention happening in each:

  1. Primary prevention when both illness and disease are absent
  2. Secondary prevention when illness is absent but disease is present
  3. Tertiary prevention when both illness and disease are present
  4. Quaternary prevention when the patient is experiencing illness but there is no identified disease

Jamoulle noted that when the patient was experiencing illness but no specific disease had been identified that patient was particularly vulnerable to their condition being made worse by invasive or harmful diagnostic medical intervention.[citation needed]

See also

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References

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  1. ^ "Jamoulle M. About prevention; the Quaternary prevention. UCL. 2008". Archived from the original on 2011-07-23. Retrieved 2011-01-11.
  2. ^ Jamoulle M. Quaternary prevention, an answer of family doctors to overmedicalization. International Journal of Health Policy and Management. 4-Feb-2015; 4:1–4.
  3. ^ Jamoulle M. Information et informatisation en médecine générale. In: Berleur J, Labet-Maris Cl, Poswick RF, Valenduc G, Van Bastelaer Ph. Les informa-g-iciens. Namur (Belgique): Presses Universitaires de Namur; 1986. p.193-209.[permanent dead link]
  4. ^ Gervás J. La prevención cuaternaria. OMC. 2004;(95):8. Archived July 26, 2011, at the Wayback Machine
  5. ^ Bentzen, Niels (2003). Wonca dictionary of general/family practice (PDF). [S.l.]: Wonca International Classification Committee. p. 115. ISBN 8788638227. Retrieved 30 May 2022.
  6. ^ Martins, Carlos; Godycki-Cwirko, Maciek; Heleno, Bruno; Brodersen, John (January 1, 2018). "Quaternary prevention: reviewing the concept: Quaternary prevention aims to protect patients from medical harm". European Journal of General Practice. 24 (1): 106–111. doi:10.1080/13814788.2017.1422177. ISSN 1381-4788. PMC 5795741. PMID 29384397.

Further reading

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