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NHS Health Check comorbidity and management: an observational matched study in primary care

John Robson, Isabel Dostal, Vichithranie Madurasinghe, Aziz Sheikh, Sally Hull, Kambiz Boomla, Chris Griffiths and Sandra Eldridge
British Journal of General Practice 2017; 67 (655): e86-e93. DOI: https://doi.org/10.3399/bjgp16X688837
John Robson
Centre for Primary Care and Public Health, Queen Mary University of London, London.
MD, FRCGP
Roles: Reader
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Isabel Dostal
Centre for Primary Care and Public Health, Queen Mary University of London, London.
MSc
Roles: Research assistant
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Vichithranie Madurasinghe
Centre for Primary Care and Public Health, Queen Mary University of London, London.
MSc
Roles: Statistician
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Aziz Sheikh
Centre for Primary Care and Public Health, eHealth Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh.
MD, FRCGP
Roles: Professor of primary care research and development
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Sally Hull
Centre for Primary Care and Public Health, Queen Mary University of London, London.
MSc, FRCGP
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Kambiz Boomla
Centre for Primary Care and Public Health, Queen Mary University of London, London.
MSc, FRCGP
Roles: Senior lecturer
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Chris Griffiths
Centre for Primary Care and Public Health, Queen Mary University of London, London.
DPhil, FRCGP
Roles: Professor of primary care
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Sandra Eldridge
Centre for Primary Care and Public Health, Queen Mary University of London, London.
PhD, FRSS
Roles: Professor of biostatistics
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This article has a correction. Please see:

  • Correction - March 01, 2017

Abstract

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.

  • cardiovascular disease
  • Health Check
  • prevention
  • primary care
  • statins
  • Received June 16, 2016.
  • Revision requested August 18, 2016.
  • Accepted September 22, 2016.
  • © British Journal of General Practice 2017
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British Journal of General Practice: 67 (655)
British Journal of General Practice
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February 2017
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NHS Health Check comorbidity and management: an observational matched study in primary care
John Robson, Isabel Dostal, Vichithranie Madurasinghe, Aziz Sheikh, Sally Hull, Kambiz Boomla, Chris Griffiths, Sandra Eldridge
British Journal of General Practice 2017; 67 (655): e86-e93. DOI: 10.3399/bjgp16X688837

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NHS Health Check comorbidity and management: an observational matched study in primary care
John Robson, Isabel Dostal, Vichithranie Madurasinghe, Aziz Sheikh, Sally Hull, Kambiz Boomla, Chris Griffiths, Sandra Eldridge
British Journal of General Practice 2017; 67 (655): e86-e93. DOI: 10.3399/bjgp16X688837
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Keywords

  • cardiovascular disease
  • health check
  • prevention
  • primary care
  • statins

More in this TOC Section

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  • Understanding primary care perspectives on supporting women’s health needs: a qualitative study
  • Inequities in hypertension management: observational cross-sectional study in North East London using electronic health records
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