| Health Care Guidelines |
When |
| Physical exam |
One visit every 24 months; annually if desired
|
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 |
Fasting plasma glucose test 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/pap test (women) |
Every two to three years |
Chlamydia and gonorrhea 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
- Colonoscopy every ten years
Those with a family history (first degree relative) of colorectal cancer, or adenomatous polyps: Begin screening at age 40, or 10 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)
|
Menopause counseling
|
Anticipatory guidance at physician discretion
|
Breast self exam
|
Anticipatory guidance at physician discretion |
Intimate partner violence
|
Anticipatory guidance at physician discretion |
| Immunizations |
When |
Td/Tdap
Tetanus, diphtheria and pertussis |
Every 10 years (Give one dose of Tdap if pertussis booster was not received previously.) |
HepA and HepB
Hepatitis A and Hepatitis B |
For high risk groups |
Var
Varicella (chickenpox) |
Two-dose series at least four weeks apart if no history of varicella or previous vaccination |
Flu
Influenza |
Annually |
Pneumococcal
Pneumonia |
For high risk groups |
Zoster
Shingles |
One dose at age 60 and older |
| Meningococcal |
For high risk groups |
| MMR |
For high risk groups |
