Peer 1 Response

 One primary care-focused visit devoted to wellness is the annual wellness visit (AWV). Components of this visit should include updating immunizations and suggesting needed immunizations, blood pressure checks to screen for hypertension, obesity counseling if needed, and any counseling for tobacco and alcohol use. Also important is doing a functional status review, screening for fall risk and cognitive abilities for seniors (Adler, 2017). If the patient were a senior with a chronic problem it would be good to do problem-focused physical exam and explore any patient concerns, if any. The Medicare Annual Wellness Visit is still an underutilized benefit for seniors, even though it can offer many benefits to increase a person’s preventive care. According to (Harvard Men’s Health Watch, 2017), this visit does not focus on a physical exam, but is instead a conversation with your health care provider about important health issues. This visit provides time for the patient to plan with their health care provider a healthy future. Other health-enhancing strategies focused on in this visit are a vision test, to detect if the patient needs glasses, a stronger prescription, or have signs of an eye disease. A balance test will be done to help gauge the risk for falls, as well as a hearing evaluation to see if the patient would benefit from a formal hearing test.

     Another part of the AWV is developing a personalized plan to address ways the patient can stay active and maintain their current health. One primary care assessment that should be done at every visit is a depression screening. This doesn’t have to be a long questionnaire, the Patient Health Questionnaire (PHQ-2) is a good screening tool. It consists of just 2 questions from the PHQ-9. If the patient screens positive with the PHQ-2, the full PHQ-9 can be completed. According (Fuchs, Haradhvala, & Uebelacker, 2015), the PHQ-2 has demonstrated strong validity and high sensitivity for detecting major depression in primary care.