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British Journal of General Practice
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Research Article

The psychological impact of cardiovascular screening and intervention in primary care: a problem of false reassurance? British Family Heart Study Group.

T M Marteau, A L Kinmonth, S Thompson and S Pyke
British Journal of General Practice 1996; 46 (411): 577-582.
T M Marteau
Psychology and Genetics Research Group, United Medical School, University of London.
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A L Kinmonth
Psychology and Genetics Research Group, United Medical School, University of London.
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S Thompson
Psychology and Genetics Research Group, United Medical School, University of London.
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S Pyke
Psychology and Genetics Research Group, United Medical School, University of London.
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Abstract

BACKGROUND: There have been many reports of the adverse psychological effects of screening. Here we discuss the results of a randomized controlled study--one of the first to address this issue. AIM: To determine the extent to which participation in a population-based intervention programme that aims to reduce the risk of cardiovascular diseases raises concerns about health, or undermines a belief in the ability to reduce that risk. METHOD: A randomized controlled trial involving 13 general practices in England, Wales and Scotland was conducted. Two thousand, nine hundred and eighty-four middle-aged men and women undergoing cardiovascular risk-screening and intervention, and a randomized comparison group of 3,576 men and women from the same practices, who were not offered the intervention, were compared on three outcomes: perception of current health, perceived risk of suffering a heart attack, and perceived ability to reduce the risk of suffering a heart attack. RESULTS: We found no evidence to suggest that participation in this one-year, population-based intervention programme, to reduce the risk of cardiovascular disease raised concerns about health or risk of a heart attack; indeed, those in the intervention group were slightly more optimistic about their health. Alterations in perceptions of current health and the risk of suffering a heart attack were associated directly with true alterations in risk factors. A more noticeable effect on participants in this intervention programme was a reduction in their perceived ability to further reduce their risks of a heart attack. This was associated with a decrease in weight and with quitting smoking. CONCLUSION: Contemporary screening and intervention programmes in primary care, aimed at reducing risk of cardiovascular disease, do not necessarily lead to raised anxiety or concern about health. A more subtle effect of screening would appear to be one of reassurance in the face of continuing, albeit reduced, risk.

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British Journal of General Practice: 46 (411)
British Journal of General Practice
Vol. 46, Issue 411
October 1996
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The psychological impact of cardiovascular screening and intervention in primary care: a problem of false reassurance? British Family Heart Study Group.
T M Marteau, A L Kinmonth, S Thompson, S Pyke
British Journal of General Practice 1996; 46 (411): 577-582.

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The psychological impact of cardiovascular screening and intervention in primary care: a problem of false reassurance? British Family Heart Study Group.
T M Marteau, A L Kinmonth, S Thompson, S Pyke
British Journal of General Practice 1996; 46 (411): 577-582.
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Print ISSN: 0960-1643
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