The Clinical Practice Subcommittee of the NPA Primary Care Committee (PCC) has reviewed current guidelines and suggestions for preventive health care and used their collective experience, knowledge, and analysis to modify the 2010 NPA Preventive Care Guideline. The 2014 Preventive Care Guideline is an update to and a further development of the 2010 Guideline.

NPA's 2014 Preventive Care Guideline (PCG) provides relevant diagnostic and management recommendations to PACE primary care providers (PCPs). The PCG was adapted specifically for PACE participants from evidence-based published guidelines for older adults using the collective review of experienced PACE Medical Directors and Primary Care Physicians and is offered with the belief that shared decision-making between individual PCPs and participants/caregivers is optimal. This PCG is not intended to replace the clinical judgment of the individual provider or establish a standard of care.

PACE participants are a heterogeneous group, with differing health profiles, prognoses, preferences, and goals of care.  Life expectancy and quality of life issues require an individualized context within which to apply practice guidelines that may have been developed from and for a population of non-frail adults. We recommend that whether a PCP follows any of the summary recommendations for an individual participant will depend upon factors specific to that participant, including the participant’s preferences, prognosis and life expectancy, co-morbid conditions, functional status, and goals of care. PACE enrollment starts at age 55, as does this guideline.

This PCG assumes that the goals of care for PACE® participants can be divided into three broad categories: promoting longevity, optimizing function, and palliative care. Accordingly, the PCG suggests different approaches depending on whether the goal is life-extension, function, or palliation. The PCP will need to determine which recommendations are appropriate for each individual participant, considering the participant’s preferences, life expectancy, and the expected benefit versus burdens of specific interventions.

Click here for a copy of the document.

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