Content: INTRODUCTION SCOPE IMPORTANCE OF HEALTH SCREENING SUCCESS OF HEALTH SCREENING TYPES OF HEALTH SCREENING ROUTINE Monitoring OF PATIENT EARLY DISEASE DETECTION SOME DISEASE AND THEIR HEALTH SCREENING SERVICE

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HEALTH
SCREENING
SERVICES IN
COMMUNITY
PHARMACY
BY: LIPANJALI BADHEI

2. z CONTENT
 INTRODUCTION
 SCOPE
 IMPORTANCE OF HEALTH SCREENING
 SUCCESS OF HEALTH SCREENING
 TYPES OF HEALTH SCREENING
 ROUTINE MONITERING OF PATIENT
 EARLY DISEASE DETECTION
 SOME DISEASE AND THEIR HEALTH SCREENING
SERVICE

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INTRODUCTION
“Health screening services are the services
provided by the health care professionals to screen
the health status of individuals with or without
positive sign and symptoms”.
 Health screening plays an important role in detecting traces of illness in
its early stages.
 It is suitable for everyone and not just for high-risk individuals or top
executives.
 In Health screening routine checkup of people are done, during that if
person has any clinical problem it will be identify and treatment start to
cure it.

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A standard health screen comprises of:
 Blood pressure measurement
 Total blood Cholesterol measurements
 Blood glucose measurement
 Body mass index measurement
 % Body fat measurement
 Lung function test
 Height & weight measurements
 Health education materials
 Provision of lifestyle advice and dietary advice and advice
on risk factors.
 Smoking cessation support
 Regular support, follow up and contact with the patient

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 Age
 Sex
 Family history
 Lifestyle
 High risk factors
Factors that determine health screening
The outcomes of health screening services are
 Early detection/diagnosis and prevention of disease
 Reduced risk factors
 Improved quality of life
 Maintain good health and well-being
 Reduce cost and future complex problems

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SCOPE
 To reduce the incidence of a condition by identifying and treating its precursors.
 To reduce mortality by early detection and early treatment of a condition.
 To reduce the severity of a condition by identifying people with the condition and offering
effective treatment.
 To increase choice by identifying conditions or risk factors at an early stage in a life-course
when more options are available.
 Early detection can make a difference between relatively simple courses of treatment or life-
threatening complications.
 Many cases of disease exist and remain undiagnosed that seriously affect our quality of life.
 Many of these conditions can be corrected or improved through a simple course of treatment if
it has been discovered by health screening.
 One of the additional benefits of health screen is peace of mind and reassurance. Health
Screening Services contribute to economic burden of the patient by early diagnosis and
prevention.
 Health screenings are convenient, affordable, comprehensive, very reliable with few false
negatives and flexible. Also it is painless, non-invasive and inexpensive tests.

7. z The importance of health screenings
 Regular health examinations and tests can help find complications
before they start.
 They also can find problems early on, when your chances for
treatment and cure are much less and complicated.
 By receiving the correct health facilities, screenings and treatments
you are taking steps that help your living chances
longer and healthier.

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Principles of early disease detection
 The condition being sought should be a significant health problem.
 The natural history of the condition should be understood.
 There should be a recognizable latent or early symptomatic stage.
 There should be a screening test or examination capable of detecting the disease in its
latent or early symptomatic stage and the test should be acceptable to the population.
 There should be an acceptable treatment for people identified as having the disease.
 Treatment in the latent or early symptomatic stages of the disease should favourably
influence its course and prognosis.
 The facilities to diagnose and treat patients identified in the screening program should
be available.
 There should be an agreed policy on whom to treat as patients.
 The cost of case-finding, including the cost of diagnosis and treatment, should be
reasonable in terms of its relationship to the cost of medical care as a whole.
 Case-finding should be a continuing process, not a "one-shot" project.

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Success of Health Screening
In a target population a successful screening Programme must be able to:
1. identify the disease at an early stage (equals“ Programme validity");
2. and improve the average prognosis of the disease.
While a screening programme must always be adapted to the actual circumstances,
some common success factors include:
 Identified target population
 Identifiable individuals
 Measures that guarantee high coverage and attendance
 Available facilities for the programme Quality control Facilities for confirmation
diagnostics, treatment and follow-up
 Managed pathways of referral and information
 Use of appropriate and quality controlled epidemiology data

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Based on composition of health screen,
it is classified in to three types
1. Standard health screen.
2. Premium health screen.
3. Executive health screen

11. z STANDARD HEALTH SCREEN:
 Consultation with health professional Blood glucose test (marker for
diabetes).
 Blood cholesterol test (total cholesterol level).
 Blood pressure measurement and evaluation.
 Body mass indexing (measures height weight ratio cardiac risk
assessment).
 Pulmonary function tests(lung capacity and screens for possible disease)
 Liver function tests (for abnormal liver function)
 Comprehensive urine analysis (test for protein, blood in urine and possible
kidney disease infection).

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PREMIUM HEALTH SCREEN:
 Comprehensive one to one consultation.
 Blood glucose test (marker for diabetes).
 Blood cholesterol test (total cholesterol levels)
 Blood pressure measurement and evaluation
 Body mass indexing (measures height and weight ratio).
 12 load ECG (Measures the electrical conduction of the heart).
 Cardiac risk assessment.
 Renal profile (blood test to check kidney function).

13. z XECUTIVE HEALTH SCREEN:
 Bone profile (blood test for measure calcium, phosphate)
 Full blood count (measures red cells, white cells, hemoglobin etc.).
 Ferritin blood test (can detect hereditary conditions such as hemochromatosis).
 Pulmonary function tests (lung capacity, and screen for possible disease).
 Liver function tests (for abnormal liver function).
 Comprehensive urine analysis (tests for protein, blood in urine and possible
kidney disease infection).
 Health body fat % range.
 Blood pressure(BP) sometimes referred to as arterial blood pressure, is the
pressure exerted by circulating blood upon the walls of blood vessels. During
each heart beat, blood pressure varies between a maximum (systolic) and a
minimum (diastolic) pressure.

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Blood Sugar
 The international standard way of measuring blood glucose levels are in terms of a molar
concentration, measured in mmol/L(millimoles per liter) or millimeter, abbreviated mm) In
the united states.
High blood sugar (Hyperglycemia)
Long term hyperglycemia causes many of the long -term health problems including heart
disease, eye, kidney and nerve damage.
Low blood sugar (hypoglycemia)
If blood sugar levels drop too low, a potentially fatal condition called hypoglycemia
develops. Symptoms may include lethargy, impaired mental functioning, irritability,
shaking twitching, weakness in arm and leg muscles, pale complexion, paranoid or
aggressive mentality and loss of consciousness.

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Lung function test
Spirometry:
 This test measures how much air you can breathe in and out. It also measures
how fast you can blow air out.
Body plethysmography:
 This test measures how much air is present in your lungs when you take a deep
breath. It also measures how much air remains in your lungs to your blood stream.
 Lung volumes.
 Arterial blood gas, shunt fraction measurement, dead space.
 Airway resistance.
 Inspiratory expiratory muscle pressures.
 Airway reactivity (methacholine / exercise challenge).
 Cardiopulmonary exercise test.

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Pulmonary function test
VT: Tidal volume: air inhaled during quiet breathing.
IRV: Inspiratory reserve volume: maximal volume inhaled from quiet breathing.
ERV: Expiratory reserve volume: maximal volume exhaled from quiet breathing.
RV Residual volume: volume remaining after maximal exhalation
Primary Lung volume:
TLC :Total lung capacity sum of 4 primary volumes.
VC : Vital capacity volume exhaled from maximal inspiration to maximal expiration.
FRC: Functional residual capacity - resting, end-expiratory volume.
IC : Maximal volume inhaled from FRC.

17. z Lung capacity
 Sum of primary lung volumes:
 Measurement of the pattern of air movement in to and out of the lungs
during controlled ventilator maneuvers.
 you will be asked to breathe through a mouth piece while wearing a nose
clip, the tester will coach you to take in as big a breath as possible. you will
then blast the air out as fast as you can until your lung are completely
empty.
 you may then be asked to take another deep breath in again.
 you will do this three times or more to make sure the results are accurate.
 The spirogram: A total cholesterol blood test is a blood test to check the
cholesterol and triglyceride in the blood.
 Total cholesterol testing is necessary to check the level of cholesterol in the
blood.

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CHOLESTEROL TEST :
 Cholesterol is used by the body to produce hormones and build cells. Excess
Cholesterol in the blood can clog artery walls and form plaque. Too much of
plaque can increase the risk of heart disease.
HDL cholesterol
This is good cholesterol that binds with fat in the blood and helps to remove it from
the body.
LDL cholesterol
Known as 'bad cholesterol'. LDL cholesterol can increase the risk of heart disease.
VLDL:
This lipoprotein distributes the triglyceride that is created by the liver.
 Excessive VLDL can increase the chances of a stroke and heart disease.

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Triglycerides:
Triglycerides are fat that is stored in the body as energy, Cholesterol attaches itself
to a protein and travels through blood.
 This package is known as a lipoprotein.
 A lipid profile test is done to check the level of total cholesterol triglycerides,
HDL cholesterol and LDL cholesterol.
 This is done to screen for a lipid disorder.
 This test is done to check how a person is responding to treatment for
lipid disorders.
 A test like this can determine if you are at a risk of getting heart disease.
 Twist test might be done to screen for diseases that cause high
cholesterol in people.

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NEED FOR SCREENING:
Quarantine of cases of an infectious disease:
 In an immunization programme, it might be necessary to
screen out those already infected.
 Direct disease at phase in its development in which there is
successful treatment.

21. z Uses of Screening
 Case detection: prescriptive screening
 Presumptive identification of unrecognized disease.
 Does not arise from patients request people screened for their own benefit.
 for example - neonatal screening. Bacteriuria in pregnancy, breast
cancer, diabetes mellitus, iron deficiency anaemia etc.
 Control of diseases: Prospective screening.
 People examined for benefit of others.
 for example-screening of immigrants for syphilis.

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TYPES OF SCREENING:
Mass Screening:
Screening of a large population or a sub group. eg. all adults. High risk or selective
screening: Applied selectively to high risk groups, the groups defined on the basis of
epidemiological research e.g., screening of cancer cervix in lower social groups.
Multiphasic screening:
Application of two screening tests in combination to a large number of people at one time. It
is very expensive.
Examples:
 Pap smear for cervical dysplasia or cervical cancer.
 Fasting blood cholesterol for heart disease.
 Fasting blood sugar for diabetes.
 Blood pressure for hypertension.
 Mammography for breast cancer.
 PSA test for prostate cancer.
 Fecal occult blood for colon cancer.
 Ocular pressure for glaucoma.
 PKU test for phenol ketonuria in new born.
 TSH for hypothyroid and hyperthyroid.

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