[Preventive activities in primary health care: identifying the agreement among evidence-based guidelines].
BACKGROUND
The purpose of this article is to identify the agreement among evidence-based guidelines about recommendations on preventive activities in low risk adults.


METHODS
For which we identified, from the 1996 US Task Force on Preventive Services Guide those preventives activities classified like A or B (recommendation in favour of provision) and like D or E (recommendation against provision), excepting those D and E recommendations based on descriptives studies or expert opinions. Both preventive activities aimed at pregnant women and children and those which are not applicable to our context were excluded. Selected preventive services were compared with the range of age, sex and periodicity in which agreement with the recommendations of American College of Physicians and Canadian Task Force on Preventive Services existed.


RESULTS
We found the following agreements. Screening activities. In favour: screening for hypercholesterolemia, hypertension, breast cancer, colorectal cancer, uterine cervix cancer, rubella, visual and hearing impairment and problem drinking. Against: cancer of prostate, lung, bladder and thyroid, and asymptomatic bacteriuria. Counseling activities. In favour: smoking, motor-vehicles injuries, alcohol consumption, unintended pregnancy. Immunizations and quimioprophylaxis. In favour: Vaccines for influenza, tetanus-diphtheria, hepatitis B and measles-mumps-rubella. Postexposure prophylaxis to hepatitis A, hepatitis B, meningococcal, rabies and tetanus.


CONCLUSIONS
We see then, that a high degree in agreement among the main guidelines exists; about the preventive activities to perform in Primary Health Services, nevertheless we observed low fulfillment of certain preventive activities in Primary Health Services, different barriers for the accomplishment from these activities were described.
Unidad Docente de Medicina Familiar y Comunitaria, Valencia. gosalbesvic@gua.es
V
V
Gosalbes Soler
S
S
Márquez Calderón
A
A
Maiques Galán
J
J
Latour Pérez
E
E
Bernal Delgado
J
J
Puig Barberá
M
M
Arranz Lázaro
D000328:Adult; D000368:Aged; D002391:Catchment Area, Health; D002648:Child; D002675:Child, Preschool; D019317:Evidence-Based Medicine; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011314:Preventive Health Services / Q000458:organization & administration*; D011320:Primary Health Care; D013030:Spain