The quaternary prevention, concept coined by the Belgian
general practitioner Marc Jamoulle, are the actions taken to identify a
patient
A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other hea ...
at risk of
overmedicalisation, to protect them from new medical invasion, and to suggest interventions which are ethically acceptable.
Quaternary prevention is the set of health activities to mitigate or avoid the consequences of unnecessary or excessive intervention of the
health system.
Gervás J. La prevención cuaternaria. OMC. 2004;(95):8.
Explanation of term
Marc Jamoulle divided medical situations into four quadrants based on if the patient was experiencing illness (i.e. if the patient experienced subjective poor health) and if the doctor had identified disease (constructed based on diagnostic criteria), with a different type of prevention happening in each:
# Primary prevention when both illness and disease are absent
# Secondary prevention when illness is absent but disease is present
# Tertiary prevention when both illness and disease are present
# Quaternary prevention when the patient is experiencing illness but there is no identified disease
Jamoulle noted that when the patient was experiencing illness but no specific disease had been identified that patient was particularly vulnerable to their condition being made worse by invasive or harmful diagnostic medical intervention.
This original explanation is more limited than the more general term listed in the Wonca International Dictionary for General/Family Practice, "action taken to identify patient at risk of overmedicalisation, to protect him from new medical invasion, and to suggest to him interventions, which are ethically acceptable".
See also
* Bioethics
Bioethics is both a field of study and professional practice, interested in ethical issues related to health (primarily focused on the human, but also increasingly includes animal ethics), including those emerging from advances in biology, m ...
* Cascade effect
A cascade effect is an inevitable and sometimes unforeseen chain of events due to an act affecting a system. If there is a possibility that the cascade effect will have a negative impact on the system, it is possible to analyze the effects with a ...
* Defensive medicine
* Iatrogenesis
Iatrogenesis is the causation of a disease, a harmful complication, or other ill effect by any medical activity, including diagnosis, intervention, error, or negligence. "Iatrogenic", ''Merriam-Webster.com'', Merriam-Webster, Inc., accessed 2 ...
* Medical ethics
* Medicalization
Medicalization is the process by which human conditions and problems come to be defined and treated as medical conditions, and thus become the subject of medical study, diagnosis, prevention, or treatment. Medicalization can be driven by new evid ...
* Medicine
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pr ...
* Patient safety
Patient safety is a discipline that emphasizes safety in health care through the prevention, reduction, reporting and analysis of error and other types of unnecessary harm that often lead to adverse patient events. The frequency and magnitude of ...
* Preventive medicine
Preventive healthcare, or prophylaxis, consists of measures taken for the purposes of disease prevention.Hugh R. Leavell and E. Gurney Clark as "the science and art of preventing disease, prolonging life, and promoting physical and mental hea ...
References
Further reading
Gofrit ON, Shemer J, Leibovici D, Modan B, Shapira SC. Quaternary prevention: a new look at an old challenge. Isr Med Assoc J. 2000;2(7):498-500.
Ortún V. Gestión clínica y sanitaria. De la práctica diaria a la academia, ida y vuelta. Barcelona: Elsevier/Masson; 2003. p.245
* [https://web.archive.org/web/20120317164646/http://www.equipocesca.org/wp-content/uploads/2009/03/prevention-lancet-final-2008.pdf Gérvas J, Starfield B, Heath I. Is clinical prevention better than cure? Lancet. 2008;372:1997-99.]
Marc Jamoulle. Paradigm shift in Primary Care working fields. 11th congress of SBMFC, Brazilia, June 2011.
Marc Jamoulle. la prévention quaternaire, une tâche explicite du médecin généraliste. Prospective Jeunesse. 2012; 7–11.
Julien Nève, Marc Jamoulle. Quaternary prevention, an explicit task of the physician. Oct 25, 2012.
Gérvas J. Prevención cuaternaria en ancianos. Rev Esp Geriatr Gerontol. 2012; 47(6):266-9.
Quaternary Prevention (P4). Revista Brasileira de Medicina de Família e Comunidade. 2015; 10(35).
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