Put Prevention Into Practice: A Systematic Approach to the Delivery of Clinical Preventive Services

CLINICAL PREVENTIVE services, including counseling interventions, screening tests, immunizations, and chemoprophylactic regimens, are important components of primary care. The process of establishing recommendations for the delivery of these services has advanced considerably during the past decade, with a shift from those that are based primarily on expert opinion to those based on a systematic review of existing scientific evidence and explicit criteria. The characterization of the science base in support of clinical preventive services now serves as a model for guideline development for clinical areas. Even so, the delivery of recommended services remains inadequate. For example, the vaccination rate of adults aged 65 years and older against pneumococcal infections is only about 20%, and the delivery for other basic types of preventive care is often less than 50%. 1 Put Prevention Into Practice (PPIP), a program that is a comprehensive, integrated, and systematic approach to the delivery of clinical preventive