Moving from Assessing Cardiovascular Risk to Altering Risk Trajectories: Opportunities Revealed by England’s NHS Health Check Programme

2021 ◽  
Author(s):  
Riyaz Patel ◽  
Sharmani Barnard ◽  
Catherine Lagord ◽  
Katherine Thompson ◽  
Andrew Hughes ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Health Check ◽  
Nhs Health Check

scholarly journals Improving cardiovascular disease risk communication in NHS Health Checks: a qualitative study

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e026058 ◽  
Author(s):  
Meredith K D Hawking ◽  
Adam Timmis ◽  
Fae Wilkins ◽  
Jessica L Potter ◽  
John Robson
Keyword(s):  
Cardiovascular Risk ◽  
Qualitative Study ◽  
Risk Communication ◽  
Risk Reduction ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Health Check ◽  
Health Checks ◽  
Nhs Health Checks ◽  
Nhs Health Check

ObjectiveThe NHS Health Check programme is a public screening and prevention initiative in England to detect early signs of cardiovascular ill health among healthy adults. We aimed to explore patient perspectives and experiences of a personalised Risk Report designed to improve cardiovascular risk communication in the NHS Health Check.Design and settingThis is a qualitative study with NHS Health Check attendees in three general practices in the London Borough of Newham.Intervention and participantsA personalised Risk Report for the NHS Health Check was developed to improve communication of results and advice. The Risk Report was embedded in the electronic health record, printed with auto-filled results and used as a discussion aid during the NHS Health Check, and was a take-home record of information and advice on risk reduction for the attendees. 18 purposively sampled socially diverse participants took part in semistructured interviews, which were analysed thematically.ResultsFor most participants, the NHS Health Check was an opportunity for reassurance and assessment, and the Risk Report was an enduring record that supported risk understanding, with impact beyond the individual. For a minority, ambivalence towards the Risk Report occurred in the context of attending for other reasons, and risk and lifestyle advice were not internalised or acted on.ConclusionOur findings demonstrate the potential of a personalised Risk Report as a useful intervention in NHS Health Checks for enhancing patient understanding of cardiovascular risk and strategies for risk reduction. Also highlighted are the challenges that must be overcome to ensure transferability of these benefits to diverse patient groups.Trial registration numberNCT02486913.

scholarly journals NHS Health Checks for people with mental ill-health 2013–2017: an observational study

2020 ◽  
Vol 29 ◽  
Author(s):  
C. Garriga ◽  
J. Robson ◽  
C. Coupland ◽  
J. Hippisley-Cox
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Events ◽  
Health Check ◽  
Health Checks ◽  
Hazard Ratios ◽  
Nationally Representative ◽  
Nhs Health Checks ◽  
Nhs Health Check

Abstract Aims People living with serious mental ill-health experience adverse cardiovascular outcomes causing some of the greatest health inequality gaps in England, UK. We describe uptake of the NHS Health Check programme in people with mental ill-health, and rates of new diagnoses and management of cardiovascular risk factors in those who attend NHS Health Checks in comparison to those people without mental ill-health. Methods We used a large nationally representative database of people registered with general practitioners in England (QResearch). Between 2013 and 2017, we analysed attendance at NHS Health Checks and outcomes in the succeeding 12 months, in people with serious mental illness (SMI) including psychoses and in people prescribed long-term antidepressant medications (LTAD), with comparison to attendees who did not have these conditions. Hazard ratios (HR) were used to describe the association between outcomes and SMI and LTAD adjusting for sociodemographic variables. Results In those eligible for the NHS Health Check programme, we found a higher percentage of people with SMI attended an NHS Health Check (65 490, 19.8%) than those without SMI (524 728, 16.6%); adjusted HR 1.05 [95% confidence interval 1.02–1.08]. We also observed a higher percentage of attendance in people on LTAD (46 437, 20.1%) compared to people who were not prescribed LTAD (543 781, 16.7%); adjusted HR 1.10 (1.08–1.13). People with SMI were more likely to be identified with chronic kidney disease (CKD, HR 1.23, 1.12–1.34) and type 2 diabetes (HR 1.14, 1.03–1.25) within the 12 months following their NHS Health Check compared with those without SMI. People on LTAD were more likely to be identified with CKD (HR 1.55, 1.42–1.70) and type 2 diabetes (HR 1.45, 1.31–1.60) and also hypertension, cardiovascular disease, non-diabetic hyperglycaemia, familial hypercholesterolemia and dementia within the 12 months following their NHS Health Check. Statins were more likely to be prescribed to NHS Health Check attendees with SMI and those on LTAD than those without these conditions; HR 1.31 (1.25–1.38) and 1.91 (1.82–2.01), respectively. Antihypertensives were more likely to be prescribed to those on LTAD; HR 1.21 (1.14–1.29). Conclusions We found evidence that people with SMI or on LTAD treatment were 5–10% more likely to access NHS Health Checks than people without these conditions. People with SMI or on LTAD treatment who attended NHS Health Checks had higher rates of diagnosis of CKD, type 2 diabetes and some other relevant co-morbidities and increased treatment with statins and also anti-hypertensive medication in people on LTAD. This is likely to contribute to equitable reduction in adverse cardiovascular events for people with mental ill-health.

scholarly journals Be SMART: examining the experience of implementing the NHS Health Check in UK primary care

2015 ◽  
Vol 16 (1) ◽  
Author(s):  
Rachel L Shaw ◽  
Helen M Pattison ◽  
Carol Holland ◽  
Richard Cooke
Keyword(s):  
Primary Care ◽  
Health Check ◽  
Nhs Health Check

scholarly journals Reasons why people do not attend NHS Health Checks: a systematic review and qualitative synthesis

2017 ◽  
Vol 68 (666) ◽  
pp. e28-e35 ◽  
Author(s):  
Emma Harte ◽  
Calum MacLure ◽  
Adam Martin ◽  
Catherine L Saunders ◽  
Catherine Meads ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Management ◽  
Health Check ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Qualitative Synthesis ◽  
Health Checks ◽  
The Impact ◽  
Nhs Health Checks ◽  
Nhs Health Check

BackgroundThe NHS Health Check programme is a prevention initiative offering cardiovascular risk assessment and management advice to adults aged 40–74 years across England. Its effectiveness depends on uptake. When it was introduced in 2009, it was anticipated that all those eligible would be invited over a 5-year cycle and 75% of those invited would attend. So far in the current cycle from 2013 to 2018, 33.8% of those eligible have attended, which is equal to 48.5% of those invited to attend. Understanding the reasons why some people do not attend is important to maximise the impact of the programmes.AimTo review why people do not attend NHS Health Checks.Design and settingA systematic review and thematic synthesis of qualitative studies.MethodAn electronic literature search was carried out of MEDLINE, Embase, Health Management Information Consortium, Cumulative Index to Nursing and Allied Health Literature, Global Health, PsycINFO, Web of Science, OpenGrey, the Cochrane Library, NHS Evidence, Google Scholar, Google, ClinicalTrials.gov, and the ISRCTN registry from 1 January 1996 to 9 November 2016, and the reference lists of all included papers were also screened manually. Inclusion criteria were primary research studies that reported the views of people who were eligible for but had not attended an NHS Health Check.ResultsNine studies met the inclusion criteria. Reasons for not attending included lack of awareness or knowledge, misunderstanding the purpose of the NHS Health Check, aversion to preventive medicine, time constraints, difficulties with access to general practices, and doubts regarding pharmacies as appropriate settings.ConclusionThe findings particularly highlight the need for improved communication and publicity around the purpose of the NHS Health Check programme and the personal health benefits of risk factor detection.

Addressing Health Inequalities Through the NHS Health Check Programme in England

2021 ◽  
Author(s):  
Riyaz Patel ◽  
Sharmani Barnard ◽  
Catherine Lagord ◽  
Katherine Thompson ◽  
Andrew Hughes ◽  
...  
Keyword(s):  
Health Inequalities ◽  
Health Check ◽  
Nhs Health Check

scholarly journals The NHS Health Check in England: an evaluation of the first 4 years

BMJ Open ◽  
2016 ◽  
Vol 6 (1) ◽  
pp. e008840 ◽  
Author(s):  
John Robson ◽  
Isabel Dostal ◽  
Aziz Sheikh ◽  
Sandra Eldridge ◽  
Vichithranie Madurasinghe ◽  
...  
Keyword(s):  
Health Check ◽  
Nhs Health Check
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