Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
NIHR Cardiovascular Biomedical Research Unit, Barts Heart Centre, London, UK.
BMJ Open. 2019 Sep 3;9(8):e026058. doi: 10.1136/bmjopen-2018-026058.
The NHS Health Check programme is a public screening and prevention initiative in England to detect early signs of cardiovascular ill health among healthy adults. We aimed to explore patient perspectives and experiences of a personalised Risk Report designed to improve cardiovascular risk communication in the NHS Health Check.
This is a qualitative study with NHS Health Check attendees in three general practices in the London Borough of Newham.
A personalised Risk Report for the NHS Health Check was developed to improve communication of results and advice. The Risk Report was embedded in the electronic health record, printed with auto-filled results and used as a discussion aid during the NHS Health Check, and was a take-home record of information and advice on risk reduction for the attendees. 18 purposively sampled socially diverse participants took part in semistructured interviews, which were analysed thematically.
For most participants, the NHS Health Check was an opportunity for reassurance and assessment, and the Risk Report was an enduring record that supported risk understanding, with impact beyond the individual. For a minority, ambivalence towards the Risk Report occurred in the context of attending for other reasons, and risk and lifestyle advice were not internalised or acted on.
Our findings demonstrate the potential of a personalised Risk Report as a useful intervention in NHS Health Checks for enhancing patient understanding of cardiovascular risk and strategies for risk reduction. Also highlighted are the challenges that must be overcome to ensure transferability of these benefits to diverse patient groups.
NCT02486913.
NHS 健康检查计划是英格兰的一项公共筛查和预防计划，旨在发现健康成年人中心血管健康不良的早期迹象。我们旨在探讨设计用于改善 NHS 健康检查中心血管风险沟通的个性化风险报告，患者的观点和体验。
这是一项在伦敦纽汉区的三家普通实践中进行的 NHS 健康检查参与者的定性研究。
为 NHS 健康检查开发了个性化的风险报告，以改善结果和建议的沟通。风险报告嵌入在电子健康记录中，打印时会自动填写结果，并作为 NHS 健康检查期间的讨论辅助工具，也是与会者关于降低风险的信息和建议的带回家记录。18 名具有社会多样性的有目的抽样参与者参加了半结构化访谈，访谈内容进行了主题分析。
对于大多数参与者来说，NHS 健康检查是一个安心和评估的机会，而风险报告是一个持久的记录，支持对风险的理解，其影响超出了个人。对于少数人来说，在因其他原因就诊的情况下，对风险报告持矛盾态度，风险和生活方式建议没有被内化或采取行动。
我们的研究结果表明，个性化风险报告作为 NHS 健康检查中的一项有用干预措施，具有增强患者对心血管风险和降低风险策略的理解的潜力。还强调了必须克服的挑战，以确保将这些益处转移到不同的患者群体中。
NCT02486913。
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