| Health Care Guidelines |
When |
| Physical exam |
One visit every 24 months; annually if desired.
|
| Health guidance |
One annual visit for anticipatory guidance for menopause counseling, vision/glaucoma check, breast self exam, glucose checks and family and intimate partner violence. |
Clinical Screenings
|
When |
| Depression screening |
During physical exam |
| Tobacco use |
During each visit |
| Alcohol misuse |
During each visit |
| Height, weight, BMI and blood pressure |
During physical exam; nutrition and physical activity counseling for those identified as high risk |
| Diabetes screening |
Every 3 years in adults with hypertension or hyperlipidemia beginning at age 45. |
| Dyslipidemia screening |
For all adults, a fasting lipoprotein profile (total cholesterol, LDL, HDL and triglyceride) should be obtained once every five years. |
Tuberculin skin test (PPD)
|
For those identified as high risk
|
| Hemoglobin and hematocrit |
Once every two years |
| Mammogram (women) |
Ages 40 to 49, every one to two years; ages 50 and older, annually |
| Cervical cancer screening (women) |
Every two to three years |
Chlamydia screening and Gohorrhea screening (STIs)
|
All sexually active women to be screened for STIs |
HIV screening
|
Annually for adults at high risk |
| Colorectal cancer screening |
Beginning at age 50, one of the following screening options:
- Fecal occult blood test annually
- Flexible sigmoidoscopy every five years
- Fecal occult blood testing annually and flexible sigmoidoscopy every five years
- Double-contrast barium enema every five years
- Colonoscopy every ten years
Those with a family history (first degree relative) of colorectal cancer, or adenomatous polyps; begin screening at age 40 or ten years before the youngest case in the immediate family. Colonoscopy every five years. |
Osteoporosis risk factor assessment (women)
|
Once every two years as part of the physical exam
Does not include bone density test
|
| Immunizations |
When |
Td/Tdap
Tetanus, diphtheria and pertussis vaccine |
Every ten years (Give one dose of Tdap if pertussis booster was not received previously.) |
HepA and HepB
Hepatitis A and Hepatitis B vaccine |
For high risk groups |
Var
Varicella (chickenpox) vaccine |
Two dose series at least four weeks apart if no history of varicella or previous vaccination. |
Flu
Influenza vaccine |
Annually |
Pneumococcal
Pneumonia vaccine |
For high risk groups |
Zoster
Shingles vaccine |
One dose at age 60 and older. |
| Meningococcal |
For high risk groups |
| MMR |
For high risk groups |
