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NHS Health Check comorbidity and management: an observational matched study in primary care
John Robson1, Isabel Dostal1, Vichithranie Madurasinghe1
1Centre for Primary Care and Public Health, Queen Mary University of London, London.
Insights
The NHS Health Check programme achieved 85% coverage, identifying more new cases of diabetes, hypertension, and chronic kidney disease in attendees. Statins were also more frequently prescribed to those who attended.
Area of Science:
- Public Health
- Cardiovascular Disease Prevention
- Health Services Research
Background:
- The National Health Service (NHS) Health Check programme aims to identify individuals at high risk of cardiovascular disease and comorbidities.
- The program offers behavioral change support and treatment to eligible participants.
Purpose of the Study:
- To evaluate the coverage and impact of the NHS Health Check programme.
- To assess its effectiveness in cardiovascular risk management and the identification of new comorbidities.
Main Methods:
- An observational 5-year study was conducted in general practices in east London.
- A matched analysis compared comorbidity rates between NHS Health Check attendees and non-attendees.
Main Results:
- The NHS Health Check programme achieved 85% coverage by 2014, with higher attendance among deprived populations and South Asians.
- Attendees were more likely to be prescribed statins (11.5% vs 8.2%).
- Newly diagnosed diabetes, hypertension, and chronic kidney disease were significantly more common in attendees compared to non-attendees.
Conclusions:
- The NHS Health Check programme demonstrated equitable provision and high recent coverage.
- The program effectively identified new cases of major comorbidities and increased statin prescription rates.
- These findings highlight the public health importance of the NHS Health Check programme in managing cardiovascular risk.
Background:
The NHS Health Check programme completed its first 5 years in 2014, identifying those at highest risk of cardiovascular disease and new comorbidities, and offering behavioural change support and treatment.
Aim:
To describe the coverage and impact of this programme on cardiovascular risk management and identification of new comorbidities.
Design And Setting:
Observational 5-year study from April 2009 to March 2014, in 139 of 143 general practices in three clinical commissioning groups (CCGs) in east London.
Method:
A matched analysis compared comorbidity in NHS Health Check attendees and non-attendees.
Results:
A total of 252 259 adults aged 40-74 years were eligible for an NHS Health Check and, of these, 85 122 attended in 5 years. Attendance increased from 7.3% (10 900/149 867) in 2009 to 17.0% (18 459/108 525) in 2013 to 2014, representing increasing coverage from 36.4% to 85.0%. Attendance was higher in the more deprived quintiles and among South Asians. Statins were prescribed to 11.5% of attendees and 8.2% of non-attendees. In a matched analysis, newly-diagnosed comorbidity was more likely in attendees than non-attendees, with odds ratios for new diabetes 1.30 (95% confidence interval [CI] = 1.21 to 1.39), hypertension 1.50 (95% CI = 1.43 to 1.57), and chronic kidney disease 1.83 (95% CI = 1.52 to 2.21).
Conclusion:
The NHS Health Check programme provision in these CCGs was equitable, with recent coverage of 85%. Statins were 40% more likely to be prescribed to attendees than non-attendees, providing estimated absolute benefits of public health importance. More new cases of diabetes, hypertension, and chronic kidney disease were identified among attendees than a matched group of non-attendees.
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