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Evaluating the clinical effectiveness of the NHS Health Check programme: a prospective analysis in the Genetics and
Radoslaw Debiec1, Daniel Lawday2, Vasiliki Bountziouka2,3
1Department of Cardiovascular Sciences and NIHR Cardiovascular Research Centre, University of Leicester, Leicester, UK rmd24@leicester.ac.uk.
Objective:
The aim of the study was to assess the clinical effectiveness of the national cardiovascular disease (CVD) prevention programme-National Health Service Health Check (NHSHC) in reduction of CVD risk.
Design:
Prospective cohort study.
Setting:
147 primary care practices in Leicestershire and Northamptonshire in England, UK.
Participants:
27 888 individuals undergoing NHSHC with a minimum of 18 months of follow-up data.
Outcome Measures:
The primary outcomes were NHSHC attributed detection of CVD risk factors, prescription of medications, changes in values of individual risk factors and frequency of follow-up.
Results:
At recruitment, 18% of participants had high CVD risk (10%-20% 10-year risk) and 4% very high CVD risk (>20% 10-year risk). New diagnoses or hypertension (HTN) was made in 2.3% participants, hypercholesterolaemia in 0.25% and diabetes mellitus in 0.9%. New prescription of stains and antihypertensive medications was observed in 5.4% and 5.4% of participants, respectively. Total cholesterol was decreased on average by 0.38 mmol/L (95% CI -0.34 to -0.41) and 1.71 mmol/L (-1.48 to -1.94) in patients with initial cholesterol >5 mmol/L and >7.5 mmol/L, respectively. Systolic blood pressure was decreased on average by 2.9 mm Hg (-2.3 to -3.7), 15.7 mm Hg (-14.1 to -17.5) and 33.4 mm Hg (-29.4 to -37.7), in patients with grade 1, 2 and 3 HTN, respectively. About one out of three patients with increased CVD risk had no record of follow-up or treatment.
Conclusions:
Majority of patients identified with increased CVD risk through the NHSHC were followed up and received effective clinical interventions. However, one-third of high CVD risk patients had no follow-up and therefore did not receive any treatment. Our study highlights areas of focus which could improve the effectiveness of the programme.
Trial Registration Number:
NCT04417387.
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