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Secondary Prevention

Secondary Prevention: The use of preventive measures, such as early screening, detection, and intervention, to reduce the impact or progression of a disease or condition.
This approach aims to minimize the burden of disease and improve health outcomes by identifying and addressing underlying risk factors or early signs of disease, before more severe or advanced stages develop.
Secondary prevention strategies may involve lifestyle modifications, medication management, or targeted interventions to halt or slow the progression of a condition.
By implementing effective secondary prevention protocols, researchers and clinicians can optimize patient care and enhance overall population health.

Most cited protocols related to «Secondary Prevention»

1
Aspirin for Primary and Secondary Prevention
Cited 23 times

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Publication 2009
Antiplatelet Agents Aspirin Cerebrovascular Accident Myocardial Infarction N-acetyl-S-(alpha-methyl-4-(2-methylpropyl)benzeneacetyl)cysteine 4-(nitrooxy)butyl ester Primary Prevention Secondary Prevention Transient Ischemic Attack Vascular Diseases
2
Vitamin D and n-3 Fatty Acids for Cardiovascular and Cancer Prevention
Cited 19 times
This randomized, double-blind, placebo-controlled, 2×2 factorial trial tested the benefits and risks of vitamin D3 (2000 IU/day) and n-3 fatty acids (1 g/day fish-oil capsule containing 840 mg of n-3 fatty acids including eicosapentaenoic acid [EPA, 460 mg] + docosahexaenoic acid [DHA, 380 mg]) in the primary prevention of cardiovascular disease and cancer among 25,871 men aged ≥50 and women aged ≥55, including 5,106 African Americans. The results are presented in two papers, with details of the full design in the accompanying paper containing the vitamin D3 data, the Supplementary Appendix, and also published earlier.5 (link), 6 (link) The protocol is posted at NEJM.org. The n-3 fatty acid dose chosen was that recommended by the American Heart Association for cardioprotection7 (link) and demonstrated as beneficial in a secondary prevention population.8 (link) The recruitment flow diagram is presented in Figure S1 in the Supplementary Appendix. Randomization to n-3 fatty acids, vitamin D, both active agents, or both placebos was completed in March 2014. Study medication ceased as planned on December 31, 2017, yielding a median intervention period of 5.3 years (range 3.8-6.1 years).
Baseline questionnaires collected data on clinical and lifestyle risk factors and included a dietary questionnaire that ascertained self-reported intake of fish and other foods. Annual questionnaires assessed adherence to and potential side effects of randomized treatments, incident major illnesses, and risk factor updates. Baseline blood samples were collected from all willing participants (n=16,956 of 25,871 [66%]) and were assayed for plasma omega-3 index (EPA+DHA as a percent of total fatty acids9 (link)) by Quest Diagnostics using liquid chromatography-tandem mass spectrometry.
Manson J.E., Cook N.R., Lee I.M., Christen W., Bassuk S.S., Mora S., Gibson H., Albert C.M., Gordon D., Copeland T., D’Agostino D., Friedenberg G., Ridge C., Bubes V., Giovannucci E.L., Willett W.C, & Buring J.E. (2018). Marine Omega-3 Fatty Acids and Prevention of Vascular Disease and Cancer. The New England journal of medicine, 380(1), 23-32.
Publication 2018
African American BLOOD Capsule Cardiovascular System Cholecalciferol Diagnosis Diet Docosahexaenoic Acids Eicosapentaenoic Acid Ergocalciferol Fatty Acids Fishes Food Liquid Chromatography Malignant Neoplasms Oils, Fish Omega-3 Fatty Acids Pharmaceutical Preparations Placebos Plasma Primary Prevention Secondary Prevention Tandem Mass Spectrometry Woman
3
Validating NIfETy Neighborhood Assessments
Cited 19 times
In addition to the random sample of census block faces, a second sampling frame was used that corresponded to the residences of an existing sample of youth. Separate and distinct from the census-driven sample described above, the BPP sample was used to validate the NIfETy instrument and method. Archival individual-level data were obtained from the Second Generation Baltimore Prevention Program (BPP) at the Johns Hopkins University Bloomberg School of Public Health Prevention Intervention Research Center (PIRC). The sample in this longitudinal epidemiological study is comprised of 678 high-risk Baltimore City youths (and their caregivers) who have been assessed annually from the fall of their entry into first grade, in 1993, to the present. Each comprehensive annual youth assessment includes multi-item modules to assess constructs such as VAOD exposure, familial management, deviant peer exposure, manifestations of anxiety and depression, injury, behavioral changes, and neighborhood/community disadvantage. These measures will be used in subsidiary analyses to compare NIfETy ratings with youth-rated neighborhood environment and community-level exposure to VAOD. Each year the caregivers are also assessed on constructs such as household structure, neighborhood/community disadvantage, and parenting practices. A subset of these constructs was used in conjunction with the NIfETy to identify specific factors within communities that are associated with increased community VAOD exposure, as reported by the youths. See Furr-Holden et al. (2004) (link) for a more detailed description of the BPP sample and instruments for this longitudinal study.
The BPP investigators provided the unit block information for the addresses of their study participants but not actual addresses. For example, if a BPP participant lived at 1614 N. Wolfe Street, the unit block information (i.e., 1600 N. Wolfe Street) was provided with an encrypted unique identifier for the participant. The NIfETy rating team was then sent to assess the entire 1600 block of N. Wolfe Street. The raters were blind to block face sampling frame; i.e., they were unaware whether they were rating a randomly sampled block face or a block face containing the residence of a BPP project participant.
Furr-Holden C.D., Smart M.J., Pokorni J.L., Ialongo N.S., Leaf P.J., Holder H.D, & Anthony J.C. (2008). The NIfETy Method for Environmental Assessment of Neighborhood-level Indicators of Violence, Alcohol, and Other Drug Exposure. Prevention science : the official journal of the Society for Prevention Research, 9(4), 245-255.
Publication 2008
Anxiety Cardiac Arrest Face Households Injuries Preventive Health Programs Reading Frames Secondary Prevention Visually Impaired Persons Youth
4
Genomic Analysis of Statin Response
Cited 18 times
All samples in our analysis were derived from the Pharmacogenomics and Risk of Cardiovascular Disease (PARC) study. The study population, experimental design, and genotyping procedures have been described in detail previously [6 (link)]. Briefly, this study contains individuals from two statin trials: the Cholesterol and Pharmacogenetics (CAP) study [8 (link)], and the Pravastatin Inflammation/CRP Evaluation (PRINCE) study [9 (link)]. The PRINCE study consists of two cohorts, one containing individuals with history of CVD (secondary prevention cohort) and the other containing individuals with no history of CVD (primary prevention cohort). Participant characteristics are summarized in Table 1.
Genotyping was conducted in two stages. The first stage individuals were genotyped on the Illumina HumanHap300 bead chip and the second stage individuals were genotyped on the Illumina HumanQuad610 bead chip and a custom-made iSelect chip. The HumanHap300 and the HumanQuad610 chips (henceforth referred to as the 300K chip and the 610K chip) were designed to tag common variation among individuals of European ancestry while 12,959 SNPs in the iSelect chip were selected to increase coverage of candidate SNPs for cardiovascular disease regardless of minor allele frequency (MAF). Our analyses reported here utilized a total of 1,868 Caucasian individuals for whom complete LDL subfraction phenotype data were available (see below).
To maximize genomic coverage and combine the multiple groups genotyped on different SNP chips, we performed genotype imputation [10 (link)] [11 (link)], using an imputation protocol that has been previously described [12 (link)]. Briefly, genotype imputation was performed using IMPUTE2 [10 (link)] with an integrated reference panel that included 120 CEU haplotypes from the 1000 Genomes Pilot Project (“1000G”) [13 (link)] and 1910 worldwide haplotypes from the HapMap Phase 3 Project (“HM3”) [14 (link)]. This procedure generated genotypes (either genotyped or imputed) for 7,836,525 SNPs.
Shim H., Chasman D.I., Smith J.D., Mora S., Ridker P.M., Nickerson D.A., Krauss R.M, & Stephens M. (2015). A Multivariate Genome-Wide Association Analysis of 10 LDL Subfractions, and Their Response to Statin Treatment, in 1868 Caucasians. PLoS ONE, 10(4), e0120758.
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Publication 2015
Cardiovascular Diseases Cholesterol DNA Chips Europeans Genome Genotyping Techniques Haplotypes Hydroxymethylglutaryl-CoA Reductase Inhibitors Inflammation Pharmacogenomic Analysis Phenotype Pravastatin Primary Prevention Secondary Prevention Single Nucleotide Polymorphism White Person
5
Prospective Surveillance of Lynch Syndrome
Cited 16 times
Each centre had identified each patient to be at increased risk of CRC according to internationally recognised guidelines1 (link)
2 (link) or local adaptations of these. Patients had then been subject to follow-up by colonoscopy and modalities for early detection of endometrial and ovarian cancer, and mutational analysis of the MMR genes. All patients in this study were proven or obligate carriers of pathogenic mutations as judged by the reporting centre in the MLH1, MSH2, MSH6 or PMS2 genes at the time of reporting. EPCAM mutations that lead to methylation of the adjacent MSH2 promoter were included and scored as MSH2 mutations. The mutations were assumed to be germline, regardless of when they were identified. All mutations reported in the 1942 patients were searched for in the Leiden open variant database (LOVD) database (http://chromium.lovd.nl/LOVD2/colon_cancer/) during October 2015: 1310 patients (67%) had pathogenic (class 5) mutations, 28 patients (1%) had probably pathogenic (class 4) mutations and the remaining 604 were not reported in LOVD.
All analysed observations were prospective, commencing when the patients were subjected to their first prospectively planned colonoscopy after being identified as at risk for colon cancer. For the purpose of this report, cases with any cancer prior to or at the same age as first colonoscopy (prevalent cancers) were excluded, as were all cases with <1 year of prospective observation time. This was done to avoid selection bias based on ascertainment and to ensure that no patient had any sign or symptom of cancer at inclusion.
The surveillance guidelines included follow-up aimed at diagnosis of colorectal adenomas or early CRC and in many centres endometrial cancer and ovarian cancer, as well as cancer awareness for all cancers known to be associated with LS. Surveillance and management guidelines have changed over time, and collaborating centres were subject to local/national decisions on how to practise at different times. None of these variations were used as variables in the present study. A detailed, referenced description of follow-up and compliance is provided in online supplementary table S2. The table and the references included there show that from the outset the reporting centres used different intervals between colonoscopies, but that from around 1996 onwards all except for the Finnish centre followed the emerging international guidelines advocating a 2-year interval or less. Intervals between gynaecological examinations were in general shorter. As previously published in the references given in the table, all visible adenomas at colonoscopies were removed. The references also show that precursor lesions were less frequently found in the endometrium or ovaries. In short, secondary prevention of colon cancer by identifying and removing precursor/early lesions was found to be promising, while this was not the case for endometrial and ovarian cancer. In consequence, all centres continued the colonoscopic surveillance, while some advised prophylactic hysterectomy and oophorectomy to prevent gynaecological cancers. All patients reported to the database had complete data sets, and there were no missing values.
Some centres had previously reported the observed incidence of cancer in their series but with different methods to those used in this report.3–11 (link) One group had reported previously on survival.4 (link) The intention of this report was to compile all information available on prospectively observed outcomes in LS patients without previous cancer and patients who were previously reported are included in the current report.
Møller P., Seppälä T., Bernstein I., Holinski-Feder E., Sala P., Evans D.G., Lindblom A., Macrae F., Blanco I., Sijmons R., Jeffries J., Vasen H., Burn J., Nakken S., Hovig E., Rødland E.A., Tharmaratnam K., de Vos tot Nederveen Cappel W.H., Hill J., Wijnen J., Green K., Lalloo F., Sunde L., Mints M., Bertario L., Pineda M., Navarro M., Morak M., Renkonen-Sinisalo L., Frayling I.M., Plazzer J.P., Pylvanainen K., Sampson J.R., Capella G., Mecklin J.P, & Möslein G. (2015). Cancer incidence and survival in Lynch syndrome patients receiving colonoscopic and gynaecological surveillance: first report from the prospective Lynch syndrome database. Gut, 66(3), 464-472.
Publication 2015
Acclimatization Adenoma Awareness Cancer of Colon Chromium Colonoscopy Condoms Diagnosis Early Diagnosis Endometrial Carcinoma Endometrium Genes Germ Line Gynecological Examination Hysterectomy Malignant Neoplasms Methylation MLH1 protein, human MSH6 protein, human Mutation Ovarian Cancer Ovariectomy Ovary pathogenesis Patients PMS2 protein, human Secondary Prevention TACSTD1 protein, human

Most recents protocols related to «Secondary Prevention»

1
Cost-Effectiveness Analysis of IraPEN
A healthcare perspective was adopted; therefore, we only included costs associated with healthcare such as direct medical costs (Table 4). The costs considered in the model are the cost of IraPEN screening, the cost of IraPEN monitoring, the cost of CHD survivors, and the cost of stroke survivors. It is assumed that the cost of individuals who are event-free in the status quo is zero as long as undiagnosed or untreated. These two facts were considered for the status quo costs. Furthermore, it was assumed that the cost of dying was equal to zero. According to PEN protocols, the needed resources for each index cohort were identified. Then, the items were quantified based on discussions with the physicians and supervisors of the visited centers. The cost of index cohorts consists of two different types. First, variable costs are different for each group based on the characteristics of each. Second, fixed cost is the same for all and consists of staff training, administration, IT, promotional stuff, and leaflets. The unit price of each item was derived from the last report of the Ministry of health (23 ). The report estimated all the costs related to IraPEN implementation except the medications. In addition, the reported costs were adjusted by the 2018 inflation rate and the cost of each cohort was calculated.
The cost of CHD state and stroke state was derived from an Iranian CE that had estimated the cost of these two states (24 (link)). These two costs contain all the related medical costs such as hospital admissions and procedures, monitoring, follow-ups, medications, and secondary prevention (Table 5). Based on experts' opinions, it is assumed that the cost of CHD after the first year would be a third and the cost of stroke state after the first year would be a quarter. In addition, it is assumed that the standard error of costs for the consecutive year is 10% of the mean.
Jamshidi A., Daroudi R., Aas E, & Khalili D. (2023). A cost-effectiveness analysis of risk-based intervention for prevention of cardiovascular diseases in IraPEN program: A modeling study. Frontiers in Public Health, 11, 1075277.
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Publication 2023
Cerebrovascular Accident PEN protocol Pharmaceutical Preparations Physicians Secondary Prevention Survivors
2
Integrated Cardiovascular Risk Management in Primary Care
The study was performed in the region Eindhoven, south-eastern part of the Netherlands, in 145 general practices affiliated to the primary care group PoZoB. The care group covers rural, suburban and urban practices similar to other parts of the Netherlands and therefore can be considered as representative. Between 2010 and 2013, 137 practices (406,119 registered patients) followed a stepwise implementation for integrated care and another 8 practices started implementation between 2013 and 2015. Eligibility for participation in integrated CVRM care was based on in- and exclusion criteria given in Table 1. Details of the stepwise implementation have been described elsewhere [16 (link)].

Criteria for participation in the CVRM program a

Inclusion criteria for patients eligible for primary prevention
● A 10 year cardiovascular mortality risk > 5%, based on the SCORE table from the 2006 CVRM guidelines of the Dutch Society of General Practice [6 (link)]
● Prescription of blood pressure lowering or lipid modifying drugs in men aged ≥ 55 years and women aged ≥ 60 years
● Systolic blood pressure > 180 mm Hg and/or total cholesterol > 8 mmol/l ever measured, independent of the 10 year mortality risk
● The patient is primarily treated in primary care and aged 18 years or above
Inclusion criteria for patients eligible for secondary prevention:
● Documented previous ischemic or atherosclerotic heart disease (myocardial infarction and angina pectoris), heart failure, atrial fibrillation, aneurysm of the abdominal aorta, peripheral arterial disease, transient ischemic attack, ischemic or hemorrhagic stroke, chronic kidney disease
● The patient is primarily treated in primary care and aged 18 years or above
Exclusion criteria for both groups were:
● Primarily treated for cardiovascular disease risk by a specialist in a hospital or at an outpatient clinic
● Diabetes mellitus (patients receive cardiovascular risk management in a diabetes care program)
● Patients younger than 18 years

aCVRM program: cardiovascular risk management program

Smits G.H., van Doorn S., Bots M.L, & Hollander M. (2023). Cardiovascular risk reduction with integrated care: results of 8 years follow up. BMC Primary Care, 24, 66.
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Publication 2023
Angina Pectoris Aortic Aneurysm, Abdominal Atrial Fibrillation Cardiovascular Diseases Cardiovascular System Cholesterol Chronic Kidney Diseases Congestive Heart Failure Coronary Arteriosclerosis Diabetes Mellitus Eligibility Determination Hemorrhagic Stroke Lipids Myocardial Infarction Patients Peripheral Vascular Diseases Pharmaceutical Preparations Primary Health Care Primary Prevention Risk Management Secondary Prevention Specialists Systolic Pressure Transient Ischemic Attack Woman Youth
3
Cardiovascular Risk Factors Prevalence
Data are presented as percentages and means with corresponding standard deviations, overall and in strata of primary and secondary prevention. Criteria for primary and secondary prevention are described in Table 1. All analyses were performed with IBM SPSS statistical software (version 22).
Smits G.H., van Doorn S., Bots M.L, & Hollander M. (2023). Cardiovascular risk reduction with integrated care: results of 8 years follow up. BMC Primary Care, 24, 66.
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Publication 2023
Secondary Prevention
4
Assessing PCI Complication Rates
The primary endpoint was a composite of PCI complications, including repeat revascularization and ISR. The secondary endpoints were repeat revascularization and ISR. Strategies for repeat revascularization at follow-up comprise DES, bare metal stenting, plain balloon angioplasty, drug-coated balloon angioplasty, and CABG. The repeat revascularization was determined by experienced interventional cardiologists regarding individual risk and patients’ decisions. To avoid counting endpoints in patients with staged PCI, we excluded the records of staged PCI and collected the endpoints under the judgment of experienced cardiologists. The ISR was defined as the presence of significant diameter stenosis (≥ 50%) at the segment inside the stent or involving its 5-mm edges.
All patients underwent follow-up CAG or CCTA in Fuwai Hospital after the baseline successful PCI. The follow-up period lasted until October 2022. Considering the high specificity of CCTA, we mainly included patients diagnosed with the absence of ISR by CCTA. For the patients with suspected ISR, a CAG confirmation was required. Importantly, the follow-up CAG and CCTA were interpreted by a panel of dependent experienced radiologists and cardiologists. The coronary revascularization and periprocedural management were performed according to current guidelines and regulations of our center. All patients have received standard secondary prevention recommended by current guidelines [2 (link)].
Guo X., Shen R., Yan S., Su Y, & Ma L. (2023). Triglyceride-glucose index for predicting repeat revascularization and in-stent restenosis in patients with chronic coronary syndrome undergoing percutaneous coronary intervention. Cardiovascular Diabetology, 22, 43.
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Publication 2023
Angioplasty, Balloon, Coronary Cardiologists Coronary Artery Bypass Surgery Heart Metals Patients Pharmaceutical Preparations Radiologist Secondary Prevention Stenosis Stents
5
Diabetes Self-Management in Black Men
To be eligible for the study, participants (n = 64) will be Black/African American men ages 21 years or older who have had a diagnosis of type 2 diabetes for a six-month period or longer. Previous studies done by this team focused on older Black men who were at least 55. The range of participants has been expanded in order to increase recruitment and allow analysis of age differences in our sample population. Additionally, it is essential that participants have transportation to attend program activities, be under the care of a physician addressing their diabetes, and be willing to attend both group delivered virtual sessions and in-person health assessments.
Four of the participants will serve as peer leaders and will attend 30 hours of training to learn skills needed to facilitate DSMS. In addition to the general inclusion criteria listed for participants, the peer leaders must also have at least an 8th grade education, have had type 2 diabetes for over one year, be actively working on their own self-management goals, and be ready to go through the training and be a peer leader.
This study team contemplated restricting eligibility to a higher-risk population of participants with A1C ≥ 8%. A majority of the preliminary data suggest that over 50% of the proposed study sample will have an A1C ≥ 8%. By focusing on all Black men with diabetes, it allows us to cast a wide net for secondary prevention and public health impact. Potential participants who meet eligibility criteria will be invited to partake in the baseline screening assessment. While the above eligibility criteria have been chosen based on previous studies, adjustments will be made to the future, larger trial, based on results and feedback from our proposed study.
Hawkins J., Sengupta S., Kloss K., Kurnick K., Ewen A., Nwawkwo R., Funnell M., Mitchell J., Jones L, & Piatt G. (2023). Michigan men’s diabetes project II: Protocol for peer-led diabetes self-management education and long-term support in Black men. PLOS ONE, 18(3), e0277733.
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Publication 2023
Black or African American CD3EAP protein, human Diabetes Mellitus Diabetes Mellitus, Non-Insulin-Dependent Diagnosis Eligibility Determination Physicians Population at Risk Secondary Prevention Self-Management

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1
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2
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3
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More about "Secondary Prevention"

Secondary prevention refers to the strategies and interventions used to detect and address the early stages of a disease or condition, with the goal of minimizing its impact and progression.
This approach aims to identify underlying risk factors or early warning signs before more advanced stages develop, thereby optimizing patient care and enhancing overall population health.
Some common examples of secondary prevention include early screening and detection methods, such as routine check-ups, diagnostic tests, and monitoring programs.
These can help identify issues at an earlier, more treatable stage.
Additionally, secondary prevention may involve lifestyle modifications, medication management, or targeted interventions to halt or slow the progression of a condition.
Researchers and clinicians utilize a variety of tools and software to support their secondary prevention efforts.
For instance, SAS version 9.4, SAS software, and SAS v9.4 are popular statistical analysis programs used to analyze data and evaluate the effectiveness of secondary prevention protocols.
Similarly, R version 3.6.1, SPSS Statistics version 21, and Stata version 14 are other software packages that can be employed in this context.
Beyond data analysis, secondary prevention can also involve the use of specialized medical products and devices.
The Cica β test I/MBL kit, for example, is a diagnostic tool used to detect early signs of certain conditions, while Sheep Blood Agar medium is a microbiological culture medium that can be used to identify potential infectious agents.
Additionally, Oracle Clinical Remote Data Capture is a platform that facilitates the collection and management of clinical data, which can be crucial for monitoring the progress of secondary prevention strategies.
By incorporating these diverse tools and techniques, researchers and healthcare professionals can optimize their secondary prevention protocols, leading to improved patient outcomes and enhanced population health.
The insights gained from the MeSH term description and the metadescription provide a solid foundation for understanding the key concepts and best practices in this critical area of preventive medicine.