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Scottish Keep Well health check programme: an interrupted time series analysis
Claudia Geue1, James D Lewsey1, Daniel F MacKay2
1Health Economics and Health Technology Assessment, University of Glasgow, Glasgow, UK.
Journal of Epidemiology and Community Health
|April 14, 2016
Summary
The Keep Well health check program in Scotland showed minimal impact on cardiovascular disease (CVD) outcomes and drug prescribing. This study suggests current screening approaches may not effectively reduce population-level CVD risk.
Area of Science:
- Public Health
- Epidemiology
- Health Services Research
Background:
- Cardiovascular disease (CVD) remains a significant public health concern.
- Health check programs aim to reduce cardiovascular risk in high-risk populations.
- The effectiveness of population-level health checks for CVD prevention is debated.
Purpose of the Study:
- To evaluate the impact of the "Keep Well" Scottish health check program on cardiovascular outcomes.
- To assess changes in CVD mortality, hospitalizations, and cardiovascular drug prescribing following the intervention.
Main Methods:
- Interrupted time series analyses were used to compare trends in outcomes.
- Participating and non-participating general practices were compared before and after the health check implementation.
- Outcomes included coronary heart disease mortality, incident hospitalizations, and prescribing of statins, antihypertensives, and antiplatelet drugs.
Main Results:
- The Keep Well intervention showed a very small impact on coronary heart disease mortality and hospitalizations.
- No significant changes were observed in the prescribing of statins, antihypertensive drugs, or antiplatelet drugs in Keep Well practices compared to non-Keep Well practices.
- Statistical analyses accounted for secular trends and seasonal variations.
Conclusions:
- The Keep Well health check program had a negligible effect on cardiovascular outcomes and prescribing in Scotland.
- Findings do not support the current screening approach used in health check programs for addressing population-level CVD.
- Randomized evaluation methods are recommended for future health program assessments to ensure reliable conclusions.
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