Among the most common health problems in the U.S. are chronic diseases, including heart disease, stroke, diabetes, and cancer. Many of these chronic diseases are linked to poor diet and lifestyle choices including tobacco use, excessive alcohol consumption, and lack of physical activity. These risk behaviors are often influenced by social determinants of health, i.e. economic, social, cultural, and political conditions, in which people are born, grow, and live.
More important is that many of these chronic diseases are preventable by simple lifestyle changes. Eating healthy foods, getting enough exercise, and staying away from tobacco and excessive alcohol use have many health benefits, including preventing the onset of certain chronic diseases.
There are many health promotion and disease prevention programs trying to empower individuals and communities to make changes that reduce the risk of developing chronic diseases, by engaging in healthy behaviors and choosing a healthy lifestyle.
Healthcare professionals play a crucial role in health promotion and disease prevention, but they often need help and guidance.
The Agency for Healthcare Research and Quality (AHRQ) was established by a U.S. government as a part of the Department of Health & Human Services (HHS) with a goal to support research to help improve the quality of health care through health promotion and disease prevention.
In 2006, AHRQ introduced Electronic Preventive Services Selector (ePSS), a 'quick, hands-on tool designed to help primary care clinicians and health care teams identify, prioritize, and offer the screening, counseling, and preventive medication services that are appropriate for their patients.'
The ePSS tool was based on the current, evidence-based recommendations of the U.S. Preventive Services Task Force (USPSTF), allowing healthcare professionals to search them by patient's age, sex, and selected behavioral risk factors.
Several years ago AHRQ also developed a mobile app named AHRQ ePSS. Although it's hard to pronounce, it's very useful, offering the same features as web-based ePSS tool, i.e. recommendations for better screening, counseling, treatment and prevention.
The app opens to simple home screen which requires you to enter your patient's age and sex, as well as selected behaviors, that could be considered as risk, i.e. was your patient ever a tobacco user and are they sexually active. Tapping on Start will bring you to the following screen displaying the results, which are broken down by the grade of recommendation (A, B, C, D, or I).
These grades are explained in sections available if you tap on More button, but in short, A or B grades means they are recommended, C means selectively recommended, D means not recommended, and I stands for uncertain.
Tapping on each of these results will open a new screen with two options: Recommendations and Risk Factor Information (if there's any), which both display additional information on that topic. Recommendations are broken down into several tabs, from General, Rationale, Clinical, Others to Tools.
You may get confused, because no matter which tab you tap on, the screen won't change. Well, at least not the upper part. To see what each of these options mean, you need to scroll down and check risk factors, rationale, clinical considerations and counseling recommendations. Nevertheless, the recommendations provide extensive and well-written information on various topics.
Certainly the most interesting part here is Tools tab, offering links to information and materials (web-based or PDF documents) about each recommendation. All tools are also available in More section, listed alphabetically, but unfortunately, without search option.
Keyword search is however available (also in More section), offering the recommendations based on the information you've entered about your patient. Tapping on recommendation, gives you all grades available for certain topic. For example, tapping on Abdominal Aortic Aneurysm will provide you with B, C, D and I recommendations, i.e. with recommendations and considerations that are recommended, not recommended (i.e. routine screening for AAA is not recommended in women who have never smoked) or uncertain (screening for women 65-75 years who have never smoked), when dealing with this condition.
App may seems confusing to some users, so if you need help, you can always tap on More and check Instructions for Use which provide more information on how to use the app, explaining grades, symbols (green stars are highest recommendation grades) and navigation.
There's also FAQ section with answers to most commonly asked questions, and Tools section, mentioned before, displaying a list of valuable sources, questionnaires, calculators, guidelines and other assessment tools, to assist providers with preventive care.
These links, however, all open in your phone's browser, which means you'll require an internet connection to see them. Ability to access these tools within the app would be much better solution.
More section also provides information about ePSS tool, as well as U.S Preventive Services Task Force. There are also Settings, which don't allow you to change any of the app's preferences. You can just enter your name, title, institution and address that would be included in the email notifications you'll receive from the app. You can also choose to include only recommended topics in those emails. So, settings are not exactly settings.
The app also allows you to save searches or to bookmark topics, which can be accessed later. You can also share information using email or messenger services.
We can conclude that the AHRQ ePSS app is an invaluable resource for healthcare providers, especially those in primary care and internal medicine, who need evidence-based recommendations from the USPSTF, in order to facilitate the practice of optimal preventive care.
Benefit: Primary care and internal medicine providers, residents, and students would benefit from this app