Cardiovascular disease risk communication in NHS Health Checks using QRISK®2 and JBS3 risk calculators: the RICO...

Area of Science:

• Cardiovascular disease prevention strategies
• Health communication and risk assessment
• Public health interventions

Background:

• The NHS Health Check is a national program for cardiovascular disease (CVD) prevention.
• Evidence is lacking on how CVD risk is communicated to promote risk-reducing behaviors.
• The impact of different CVD risk calculators on communication is unclear.

Purpose of the Study:

• To explore practitioner and patient understanding of CVD risk during health checks.
• To examine advice and treatment offered by practitioners.
• To assess patient responses to risk communication using QRISK®2 or JBS3 calculators.

Main Methods:

• Qualitative study with quantitative process evaluation.
• 173 patients and 15 practitioners in 12 West Midlands general practices.
• Video-recorded consultations analyzed, with patient and practitioner interviews.

Main Results:

• Health checks were often brief (<20 minutes) with limited CVD risk discussion.
• JBS3 calculator use led to more risk discussion and less practitioner dominance than QRISK2.
• Patient understanding and risk-reducing behavior change were limited, with missed opportunities for tailored communication.

Conclusions:

• Brief communication and limited patient understanding hinder CVD risk reduction in health checks.
• JBS3's heart age and visual risk tools improved patient engagement and discussion.
• Enhanced practitioner training and consultation time are needed for effective risk communication and action planning.