What aspects of health should well-woman visits cover? Researchers examine the evidence
New Featured Study in Women’s Health Issues: Eight Priority Areas for the Well-Woman Visit
With recent guidelines recommending pap smears for cervical cancer screening only every three to five years for low-risk women, questions have arisen about the value of women’s routine annual visits. At the same time, the Affordable Care Act guarantees insured women coverage for annual well-woman visits without copayments or other cost-sharing, which might encourage more women to see their doctors each year. In the Editor’s Choice study in the latest issue of the journal Women’s Health Issues, Alisa Pascale of Massachusetts General Hospital and her colleagues conducted a scoping review of the literature to identify priority areas for today’s well-woman visits.
Pascale and her co-authors began by identifying the top causes of death and disability, as well as modifiable risk factors, for US women. They identified eight priority areas the well-woman visit might be able to address and searched for publications in each of them. The eight areas are: 1) reproductive life planning and sexual health, 2) cardiovascular disease and stroke, 3) prevention, screening, and early detection of cancers, 4) unintended injury, 5) anxiety, depression, substance abuse, and suicidal intent, 6) intimate partner violence, assault, and homicide, 7) lower respiratory disease, and 8) arthritis and other musculoskeletal problems.
In each of the priority areas, the authors summarized key findings and steps providers can take to help women achieve better health outcomes. For instance, they report that evidence supports consistent and integrated reproductive life planning (RLP) to help reduce unintended and mistimed pregnancies and their consequences, while promoting fertility and healthy pregnancies when women want to conceive. For heart health, the authors note, measuring and counseling women about their blood pressure, body mass index, tobacco use, and other risk factors can help prevent cardiovascular disease and stroke.
The study discusses changes that will be necessary to shift the focus of the annual well-woman visit (WWV), including education and support for providers learning to use screening and counseling interventions in the eight priority areas, and better reimbursement for the most effective interventions. Pascale and her colleagues conclude, “It is time for health care providers and policymakers alike to rebrand the WWV visit of today as a yearly comprehensive visit for RLP, prevention, screening, and health promotion—not just a pap smear and pelvic examination anymore.”
The full text of this Editor’s Choice article is available for free on the Women’s Health Issues website. Editor’s Choice articles from past issues are listed on the Free Editor’s Choice Collection Page. Women’s Health Issues is the peer-reviewed journal of the Jacobs Institute of Women’s Health, which is part of the Milken Institute School of Public Health at the George Washington University.