Robson John, Dostal Isabel, Madurasinghe Vichithranie, Sheikh Aziz, Hull Sally, Boomla Kambiz, Griffiths Chris, Eldridge Sandra
Centre for Primary Care and Public Health, Queen Mary University of London, London.
Centre for Primary Care and Public Health, eHealth Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh.
Br J Gen Pract. 2017 Feb;67(655):e86-e93. doi: 10.3399/bjgp16X688837. Epub 2016 Dec 19.
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.
To describe the coverage and impact of this programme on cardiovascular risk management and identification of new comorbidities.
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.
A matched analysis compared comorbidity in NHS Health Check attendees and non-attendees.
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).
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.
英国国民健康服务（NHS）健康检查计划于2014年完成了首个5年，识别出心血管疾病和新发合并症风险最高的人群，并提供行为改变支持和治疗。
描述该计划在心血管风险管理及新发合并症识别方面的覆盖范围和影响。
2009年4月至2014年3月进行的一项为期5年的观察性研究，涉及伦敦东部三个临床委托小组（CCG）中143家全科诊所中的139家。
采用匹配分析比较NHS健康检查参与者和非参与者的合并症情况。
共有252259名40 - 74岁成年人符合NHS健康检查条件，其中85122人在5年内参加了检查。参与率从2009年的7.3%（10900/149867）增至2013年至2014年的17.0%（18459/108525），覆盖范围从36.4%增至85.0%。在较贫困五分位人群和南亚裔中参与率更高。11.5%的参与者和8.2%的非参与者被开具了他汀类药物。在匹配分析中，参与者中新诊断出合并症的可能性高于非参与者，新诊断糖尿病的比值比为1.30（95%置信区间[CI]=1.21至1.39），高血压为1.50（95%CI =1.43至1.57），慢性肾病为1.83（95%CI =1.52至2.21）。
这些CCG中的NHS健康检查计划实施具有公平性，近期覆盖范围达85%。参与者被开具他汀类药物的可能性比非参与者高40%，带来了具有公共卫生重要性的估计绝对益处。与匹配的非参与者组相比，参与者中识别出更多糖尿病、高血压和慢性肾病新病例。
