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

Br J Gen Pract. 2017 Feb;67(655):e86-e93. doi: 10.3399/bjgp16X688837. Epub 2016 Dec 19.

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.

Keywords: Health Check; cardiovascular disease; prevention; primary care; statins.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Cardiovascular Diseases / diagnosis*
  • Case-Control Studies
  • Comorbidity
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Directive Counseling*
  • Early Diagnosis
  • England
  • Female
  • Health Behavior
  • Health Promotion*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Male
  • Mass Screening* / organization & administration
  • Middle Aged
  • Primary Health Care*
  • Program Evaluation
  • Renal Insufficiency, Chronic / diagnosis*
  • Risk Assessment
  • Sex Distribution
  • State Medicine* / organization & administration
  • State Medicine* / standards

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors