Primary prevention refers to actions aimed at avoiding the manifestation of a disease, including actions to modify behavioural and medical health risks e. Secondary prevention deals with early detection of disease and interventions to deliver positive health outcomes e. The clinical management of chronic non-communicable diseases has frequently been separated into primary and secondary prevention.
Secondary prevention is widely accepted, if not implemented, within clinical careβan event has happened that is often easily recognisable, usually if not always ensuring the presentation of the patient to a care provider and, finally, is seen to trigger a management pathway of investigation and treatment. The other concept of primary and secondary reflects the setting of the care provider; provision of event detection and management in primary care GP, family physician, community settings or in secondary care hospital, specialist clinic etc.
Events, by their nature, often lead to secondary care investigation and management with care in the immediate aftermath of the event often driven by established clinical protocols. However, the long-term care and management is then often transferred back to primary care; the latter requires excellent communication, education and understanding of the treatment goals so that long-term measures are provided and monitored to ensure the best possible outcome in individual patients.
Finally, the delineation of primary and secondary prevention is not totally an event driven phenomenon. While primary prevention is driven by the awareness of an increased risk in an individual prior to the event, the likelihood of an event in any individual, even in those with a first event, can vary markedly depending on the co-existence of other health conditions and risk factors. In this concept, the event can be seen as yet another risk factor to be considered, and rather than an automatic trigger for treatment should be seen as a trigger for risk assessment with subsequent treatment driven by the risk of future event.
These different concepts will be addressed in this presentation. Osteoporosis is a chronic condition requiring long-term, even life-long therapy. Different strategies are appropriate at different stages of life and for different levels of fracture risk. During years of skeletal growth, being healthy with good nutrition and regular physical activity are important to optimize peak bone mass as is achieving normal puberty during adolescence.
