Key Preventive Care Services Recommendations from USPSTF in 2022

May 25, 2022 - In the first half of 2022, the US Preventive Services Task Force (USPSTF) has issued several recommendations intended to promote effective preventive care services.

The USPSTF recommendations may more directly impact providers, but they have implications for payers as well. Quality measurement organizations, like the National Committee for Quality Assurance, may rely on USPSTF recommendations to form the basis and evidence both for specific quality measures and to inform overarching goals.

USPSTF offers recommendations on a scale from A grade to D grade, with A grade recommendations indicating that the services are strongly recommended and D grade recommendations indicating that the services are discouraged. An I grade indicates that evidence for the service is lacking and the task force could not make an informed recommendation.

Finalized recommendations

Using aspirin to prevent heart attack or stroke received two grade recommendations from USPSTF based on the member’s age.

It received a C grade recommendation for individuals ages 40 to 59. 

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USPSTF recommended that the preventive care approach might be appropriate for individuals who are already at high risk for cardiovascular disease and who have not already had cardiovascular disease. A member’s chance of bleeding should be taken into account when determining whether this is the best preventive care option.

However, this strategy is not appropriate for individuals who are over the age of 60. USPSTF assigned the preventive care approach a D grade for individuals in this category. Nor is aspirin an appropriate approach for people who have had a stroke or who already take aspirin.

Screening for chronic obstructive pulmonary disease (COPD) is not recommended for individuals who do not show signs of developing COPD, according to USPSTF which assigned the preventive care approach D grade.

COPD is the sixth leading cause of death in the US, the UPSTF noted. Despite the severity of this disease, the task force found that individuals who do not exhibit signs of COPD do not achieve a strong health benefit from being screened.

Still, healthcare professionals should be aware of the causes of COPD—primarily smoking—and help members with smoking cessation. Smoking-related health issues are some of the most expensive health conditions in the US.

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UPSPSTF also issued final recommendations in the first half of 2022 that indicated the need for more research on certain preventive care strategies.

The effectiveness of screening for glaucoma and impaired visual acuity for those who have not reported symptoms is still uncertain, according to USPSTF. The task force left it to healthcare professionals’ judgment regarding whether or not to screen members for glaucoma or impaired visual acuity.

Glaucoma and impaired visual acuity can be particularly prominent in Black and Hispanic individuals. Family history and age are also risk factors.

Screening for atrial fibrillation—also known as AFib—received an I grade because the USPSTF did not consider the evidence sufficient for a recommendation.

USPSTF had previously assessed the efficacy of ECGs for atrial fibrillation screening and also concluded that the evidence was insufficient, according to a JAMA Network article. In the latest update, USPSTF studied several additional screening methods but still did not find conclusive evidence for whether or not these methods are effective.

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Screening for eating disorders in members without symptoms also has been issued an I grade recommendation due to the lack of sufficient evidence.

While there is plenty of evidence indicating the seriousness of eating disorders and the harm they can inflict on mental, social, and physical health, it is unclear whether screening for these conditions in people who do not show any eating disorder symptoms would have positive or negative impacts. 

In USPTF’s analysis that was published in JAMA Network, not a single study out of 57 studies related to eating disorders assessed the value of screening.

The task force recommended that providers be aware of and alert to developing symptoms and be able to refer members who need eating disorder treatment to care.

Draft recommendations

USPSTF also published draft recommendations in the first half of 2022.

The USPSTF published a draft recommendation supporting behavioral counseling for adults without cardiovascular risk factors for members depending on their context, a C grade recommendation. The draft grade recommendation is higher for individuals who are at-risk of developing cardiovascular disease.

A trained counselor should conduct the counseling sessions and can support the member with dietary or physical activity counseling, based on the member's goals.

The task force noted that individuals who are ready to make changes to their lives in order to improve their health have the best outcomes from behavioral healthcare counseling.

Screening for syphilis infection (syphilis) among adolescents and non-pregnant adults received an A grade recommendation in a draft recommendation from USPSTF. The prevalence of syphilis has been growing over the past two decades, leading to the demand for more preventive care.

USPSTF suggested that clinicians examine the rates of syphilis infection in their communities as well as patients’ histories of HIV, incarceration, sex work, military service, and sexual activity and orientation.

The draft recommendation also highlighted the health equity considerations tied to this disease, which is more prevalent among minority groups due to access to care barriers and social determinants of health.

Other draft recommendations included a recommendation on statin use as primary prevention for cardiovascular disease, obstructive sleep apnea screenings, screening for anxiety, depression, and suicide risk in children and adolescents, and hormone therapy for chronic disease prevention in postmenopausal people. All of the comment periods for these drafts have closed.