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Do health checks improve risk factor detection in primary care? Matched cohort study using electronic health records

Forster, AS; Burgess, C; Dodhia, H; Fuller, F; Miller, J; McDermott, L; Gulliford, MC; (2016) Do health checks improve risk factor detection in primary care? Matched cohort study using electronic health records. Journal of Public Health , 38 (3) pp. 552-559. 10.1093/pubmed/fdv119. Green open access

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Abstract

BACKGROUND: To evaluate the effect of NHS Health Checks on cardiovascular risk factor detection and inequalities. METHODS: Matched cohort study in the Clinical Practice Research Datalink, including participants who received a health check in England between 1 April 2010 and 31 March 2013, together with matched control participants, with linked deprivation scores. RESULTS: There were 91 618 eligible participants who received a health check, of whom 75 123 (82%) were matched with 182 245 controls. After the health check, 90% of men and 92% of women had complete data for blood pressure, total cholesterol, smoking and body mass index; a net 51% increase (P < 0.001) over controls. After the check, gender and deprivation inequalities in recording of all risk factors were lower than for controls. Net increase in risk factor detection was greater for hypercholesterolaemia (men +33%; women +32%) than for obesity (men +8%; women +4%) and hypertension in men only (+5%) (all P < 0.001). Detection of smoking was 5% lower in health check participants than controls (P < 0.001). Over 4 years, statins were prescribed to 11% of health -check participants and 7.6% controls (hazard ratio 1.58, 95% confidence interval 1.53-1.63, P < 0.001). CONCLUSION: NHS Health Checks are associated with increased detection of hypercholesterolaemia, and to a lesser extent obesity and hypertension, but smokers may be under-represented.

Type: Article
Title: Do health checks improve risk factor detection in primary care? Matched cohort study using electronic health records
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/pubmed/fdv119
Publisher version: https://doi.org/10.1093/pubmed/fdv119
Language: English
Additional information: Copyright © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: cardiovascular diseases, cardiovascular risk, deprivation, electronic health records, gender, health inequalities, primary care, screening
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
URI: https://discovery.ucl.ac.uk/id/eprint/10087215
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