Practice Guidelines in Primary Care 2002. By Ralph Gonzales and Jean S. Kutner. 181 pp. New York, McGraw Hill Medical, 2002. $14.95 (paper). ISBN 0–07-137797-2
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* James J. Bergman

This palm-sized paperback reference offers a host of primary care guidelines in the areas of disease screening, disease prevention, and disease management. An annual update, this edition documents each topic with recent major, national organization recommendations or evidence-based citations.

Disease screening addresses the standard concerns in primary care, such as screening for cancer, hyperlipidemia, obesity, osteoporosis, alcohol abuse, and depression. Each area has a table comparing opinions from various authorities (US Public Service Task Force, American Cancer Society, American Academy of Family Physicians [AAFP]) as well as notes defining special circumstances and added commentary.

Disease prevention is primarily concerned with immunizations, featuring American College of Physicians and AAFP recommendations (includes varicella and pneumococcal vaccines). Additional reviews discuss cancer, myocardial infarction, osteoporosis, and stroke prevention methods. Often algorithms provide the reader with a concise presentation of specific disease prevention.

Disease management guidelines prove to be the most practical aspect of the book, with evidenced-based recommendations for such disorders as atrial fibrillation, asthma, congestive heart failure, depression, diabetes, hypertension, low back pain, hormone replacement therapy, and urinary tract infections. Excellent algorithms are used, and each management guideline is described succinctly and with superb documentation. These are state-of-the-art clinical guidelines for patient care decision making.

The Appendix gives the clinician quick access to the standard screening tools for depression, alcohol abuse, and dementia, and cognitive dysfunction.

There is a strong emphasis on evidence-based clinical pathways and guidelines in current medical practice, and this compact reference proves extremely helpful in day-to-day office practice. The clinician who relies on such pathways in patient care cannot help but appreciate the efficacy of this guide.