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Prevenção secundária na população pediátrica
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Introdução: O contacto frequente das crianças e adolescentes com o médico de família nas unidades de saúde faz com que estas sejam um local importante para fornecer recomendações e implementar medidas preventivas. Os rastreios, fundamentais na prevenção secundária, visam a deteção precoce de doença, na fase assintomática, quando o tratamento ainda pode travar a sua progressão. Objetivos: O objetivo da presente revisão é identificar os atos de prevenção secundária atualmente recomendados por autoridades de saúde/organizações médicas até os 18 anos (inclusive). Como objetivos secundários procura-se identificar atos de prevenção secundária recomendados com relação benefício/risco favorável, de acordo com a U.S. Preventive Services Task Force (USPSTF) e averiguar entre estes os que não constam no Programa Nacional de Saúde Infantil e Juvenil (PNSIJ). Métodos: Realização de pesquisa bibliográfica nos sites da Sociedade Portuguesa de Neonatologia, Sociedade Portuguesa de Pediatria, Direção-Geral da Saúde, American Academy of Pediatrics, USPSTF e Royal Australian College of General Practitioners. Foram incluídas recomendações publicadas entre 1 de junho de 2013 e 31 de março de 2024 sobre deteção precoce de doença desde o nascimento até os 18 anos (inclusive). Foram excluídas recomendações sobre deteção precoce de doença durante a gravidez. As recomendações foram selecionadas com base na leitura do título e resumo respetivos.Resultados: Foram obtidas 31 referências bibliográficas. Identificaram-se 19 atos de prevenção secundária atualmente recomendados, 7 com uma relação benefício/risco favorável, de acordo com a USPSTF. Entre os atos identificados, 5 não constam no PNSIJ. Discussão e conclusão: A prevenção secundária na população pediátrica é de extrema relevância. Há que considerar a incorporação no PNSIJ de atitudes preventivas com relação benefício/risco favorável, tendo em conta fatores como a prevalência de cada doença em Portugal, a disponibilidade e o custo dos recursos necessários para o rastreio, investigação diagnóstica e tratamento subsequentes.
Introduction: Frequent contact of children and adolescents with the family physician at healthcare facilities makes these places important for providing recommendations and implementing preventive measures. Screenings are essential in secondary prevention, aiming at the early detection of diseases in the asymptomatic phase, when treatment can still halt their progression. Objectives: The aim of this review is to identify secondary prevention interventions currently recommended by health authorities and medical organizations up to 18 years of age. As secondary objectives, we seek to identify secondary prevention interventions with a favorable benefit/risk ratio, as defined by the U.S. Preventive Services Task Force (USPSTF), and to ascertain which of these interventions are not included in the National Child and Youth Health Program (PNSIJ). Methods: A bibliographic search was conducted on the websites of the Portuguese Society of Neonatology, Portuguese Society of Pediatrics, Directorate-General of Health, American Academy of Pediatrics, USPSTF, and Royal Australian College of General Practitioners. Recommendations published between June 1, 2013, and March 31, 2024, on early disease detection from birth to 18 years of age were included. Recommendations on early disease detection during pregnancy were excluded. Recommendations were selected based on their respective titles and abstracts.Results: 31 bibliographic references were obtained. 19 currently recommended secondary prevention acts were identified, 7 with a favorable benefit/risk ratio according to the USPSTF. Of the identified acts, 5 are not included in the PNSIJ. Discussion and Conclusion: Secondary prevention in the pediatric population is extremely relevant. The incorporation into the PNSIJ of preventive measures with a favorable benefit/risk ratio should be considered, taking into account factors such as the prevalence of each disease in Portugal, the availability and cost of resources necessary for screening, diagnostic investigation, and subsequent treatment.
Introduction: Frequent contact of children and adolescents with the family physician at healthcare facilities makes these places important for providing recommendations and implementing preventive measures. Screenings are essential in secondary prevention, aiming at the early detection of diseases in the asymptomatic phase, when treatment can still halt their progression. Objectives: The aim of this review is to identify secondary prevention interventions currently recommended by health authorities and medical organizations up to 18 years of age. As secondary objectives, we seek to identify secondary prevention interventions with a favorable benefit/risk ratio, as defined by the U.S. Preventive Services Task Force (USPSTF), and to ascertain which of these interventions are not included in the National Child and Youth Health Program (PNSIJ). Methods: A bibliographic search was conducted on the websites of the Portuguese Society of Neonatology, Portuguese Society of Pediatrics, Directorate-General of Health, American Academy of Pediatrics, USPSTF, and Royal Australian College of General Practitioners. Recommendations published between June 1, 2013, and March 31, 2024, on early disease detection from birth to 18 years of age were included. Recommendations on early disease detection during pregnancy were excluded. Recommendations were selected based on their respective titles and abstracts.Results: 31 bibliographic references were obtained. 19 currently recommended secondary prevention acts were identified, 7 with a favorable benefit/risk ratio according to the USPSTF. Of the identified acts, 5 are not included in the PNSIJ. Discussion and Conclusion: Secondary prevention in the pediatric population is extremely relevant. The incorporation into the PNSIJ of preventive measures with a favorable benefit/risk ratio should be considered, taking into account factors such as the prevalence of each disease in Portugal, the availability and cost of resources necessary for screening, diagnostic investigation, and subsequent treatment.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2024
Palavras-chave
Prevenção Rastreio Cuidados de saúde primários Criança Adolescente