A study evaluating the largest risk assessment and management program for cardiovascular diseases, called the ‘NHS Health Check’ and run by National Health Institute, UK, reveal a minimal beneficial health effects for the patients of ages 40-74 years. The study was published in the Canadian Medical Association Journal on May 2, 2016. The findings of the study showed that the program helps in preventing just one heart attack or stroke for every 4,762 people who visit a GP for a checkup that directs towards the inefficiency of this program costing approximately £ 165m to the government.
The researchers from Imperial College, London, examined the electronic medical records of 138,788 patients aged 40-74, from 2009 to 2013. Afterwards the changes in results of patients who attended a health check were compared with those who did not, over a median follow-up of two years. The study was funded by the Department of Health, UK. It was found that 21% of the eligible population attended a health check. When compared with people who did not show up for a checkup with those who got checked, it was shown that it only reduced the 10-year risk of suffering cardiovascular disease by 0.21%. The number of people diagnosed with high blood pressure raised to 3% as a result of health checks and only 1.31% rise in the number diagnosed with diabetes was observed.
The results from the study also established that despite the fact that the diagnosis of vascular disease increased and the program showed statistically significant results but these results in clinical settings had a very marginal impact on the cardiovascular disease diagnosis in reality. This points out towards the overall sub-standardized program performance as compared to the national and international targets and highlights towards developing smart initiatives for better planning, monitoring and evaluation strategies.
Kiara Chang, lead author of the research from the School of Public Health at Imperial College, suggested that the findings of the study put the efficacy of the program under questioning. She explained that cardiovascular diseases are a leading cause of death worldwide, therefore immediate and effective actions are required to overcome the detrimental health effects.
NHS Health Check Program
A fellow colleague characterized the NHS program as flawed and highlighted the worth of their research study by saying that the program needs better strategy and planning, and the research work done by them would help in guiding the way to achieve that goal. He also said that it would be interesting to investigate the reasons behind the modest results of the healthcare program, which can be even analyzing the advice given to the patients during the health check. The researcher also directed towards their next study plans by saying, “In future we plan to evaluate whether particular groups – for instance older patients – have greater health benefits from the checkups than younger patients.”
It should be noted that the UK NHS Health Check is a program offered every five years that provides a chance to get free midlife health checkup for the adults in England aged 40-74 without a pre-existing vascular disease conditions. It checks the circulatory and vascular health of the attendee and evaluates the risks of getting a serious vascular disease.
The health checkups are necessary as they can trace the higher risk of developing potentially dangerous conditions associated with old age such as: high blood pressure, heart disease or type-II diabetes. The health programs like NHS Health Check can identify the early indicators of the disease and can assist in providing prevention strategies to avoid or manage these serious health complications, including lifestyle modifications or prescription of medication.
The procedure followed by general practitioners for these checkups include giving a score according to the risk of the cardiovascular diseases based on the common factors such as blood pressure, cholesterol levels, body mass index (BMI), age and gender and then medication is prescribed; mostly statin drugs to lower their cholesterol levels. During the current study, statins were prescribed to 40% of people considered at high risk of cardiovascular disease.
“Our results highlight the need for careful monitoring and evaluation of risk assessment programs for cardiovascular disease internationally. They also emphasize the need for high-quality research to identify effective strategies to improve program performance,” the researchers wrote in the CMAJ paper, while concluding their research work.
The healthcare program under consideration has been criticized before in 2013 and the GPs from the Royal College said that these checks were just a method of wasting money. Moreover, in 2012, research by Cochrane group found that they did not reduce deaths, according to The Guardian.
Jamie Waterall, who is the leader for the national health checkups at Public Health England, while defending the healthcare program, said: “It is important that we review all emerging evidence for this program. PHE has an established expert group which will look at the findings of this study.”