Integrating Genetics Into Primary Care: Family History Is Key

Lorie M. Vandenbusche, RN, MSN, FNP

Disclosures

Topics in Advanced Practice Nursing eJournal 

In This Article

Prevent, Detect, and Manage Disease

Once a patient has been identified to be at an increased risk, the provider can often implement screening strategies and methods for disease prevention. Some patients at increased risk may already have begun to manifest disease. For these individuals, providers can often identify disease and suggest targeted lifestyle changes such as diet, exercise, and smoking cessation. The emphasis on disease prevention and management based on the family history often motivates a change in behavior that forestalls disease or reduces its adverse effects.

It is crucial for primary care providers to understand recommendations based on family history for screening for the normal population and those at risk. The US Preventive Services Task Force (USPSTF) publishes a pocket guide with recommendations for screening, counseling, and preventive medication.[21] Based on systematic evidence reviews, the guide provides recommendations based on family history ( Table 4 ).

Although the Guide to Clinical Preventive Services is appropriate for quick access of recommendations made by the US Preventive Services Task Force, additional evidence based practice guidelines are usually necessary to make specific patient intervention decisions (ie, dosage for aspirin chemoprevention). The National Guideline Clearinghouse (NGC) is a comprehensive database of evidence-based clinical practice guidelines and is an excellent resource for clinicians to further explore evidence for specific patient recommendations.

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