Public Health England Behavioural Insights, London, UK; visiting professor in practice, Centre for Philosophy of Natural and Social Sciences, London School of Economics and Political Science, London, UK.
Public Health England Behavioural Insights, London, UK; director of innovation and program development, Vera Institute of Justice, New York, US.
Br J Gen Pract. 2021 Aug 26;71(710):e693-e700. doi: 10.3399/BJGP.2020.0887. Print 2021 Sep.
Public Health England wants to increase the uptake of the NHS Health Check (NHSHC), a cardiovascular disease prevention programme. Most invitations are sent by letter, but opportunistic invitations may be issued and verbal invitations have a higher rate of uptake. Prompting staff to issue opportunistic invitations might increase uptake.
To assess the effect on uptake of automated prompts to clinical staff to invite patients to NHSHC, delivered via primary care computer systems.
Pseudo-randomised controlled trial of patients eligible for the NHSHC attending GP practices in Southwark, London.
Eligible patients were allocated into one of two conditions, (a) Prompt and (b) No Prompt, to clinical staff. The primary outcome was attendance at an NHSHC.
Fifteen of 43 (34.88%) practices in Southwark were recruited; 7564 patients were eligible for an NHSHC, 3778 (49.95%) in the control and 3786 (50.05%) in the intervention. Attendance in the intervention arm was 454 (12.09%) compared with 280 (7.41%) in the control group, a total increase of 4.58% (OR = 2.28; 95% CI = 1.46 to 3.55; <0.001). Regressions found an interaction between intervention and sex (OR = 0.65; 95% CI = 0.44 to 0.86, = 0.004), with the intervention primarily effective on males. Comparing the probabilities of attendance for each age category across intervention and control suggests that the intervention was primarily effective for younger patients.
Prompts on computer systems in general practice were effective at improving the uptake of the NHSHC, especially for males and younger patients.
英国公共卫生部希望提高国民保健制度健康检查（NHSHC）的参与率，这是一项心血管疾病预防计划。大多数邀请都是通过信件发出的，但也可以发出机会性邀请，口头邀请的参与率更高。提示工作人员发出机会性邀请可能会增加参与率。
评估通过初级保健计算机系统向临床工作人员发送自动提示以邀请患者参加 NHSHC 对参与率的影响。
在伦敦南华克的符合 NHSHC 条件的 GP 诊所进行的患者的伪随机对照试验。
将符合条件的患者分配到两个条件之一，（a）提示和（b）不提示临床工作人员。主要结果是参加 NHSHC。
南华克的 43 个实践中有 15 个被招募；7564 名患者有资格参加 NHSHC，对照组 3778 名（49.95%），干预组 3786 名（50.05%）。干预组的出勤率为 454（12.09%），对照组为 280（7.41%），总增加率为 4.58%（OR=2.28；95%CI=1.46 至 3.55；<0.001）。回归发现干预和性别之间存在交互作用（OR=0.65；95%CI=0.44 至 0.86， = 0.004），干预对男性效果更为显著。比较干预组和对照组每个年龄组的出勤率概率表明，干预主要对年轻患者有效。
在一般实践中的计算机系统上的提示对于提高 NHSHC 的参与率非常有效，特别是对于男性和年轻患者。
