Increasing uptake of NHS Health Checks: A randomised controlled trial using GP computer prompts

Natalie Gold; Karen Tan; Joseph Sherlock; Robin Watson; Tim Chadborn

doi:10.3399/BJGP.2020.0887

Increasing uptake of NHS Health Checks: A randomised controlled trial using GP computer prompts

Natalie Gold^*, Karen Tan, Joseph Sherlock, Robin Watson, Tim Chadborn

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

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Abstract

Background: 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.

Aim: To assess the effect on uptake of automated prompts to clinical staff to invite patients to NHSHC, delivered via primary care computer systems.

Design and setting: Pseudo-randomised controlled trial of patients eligible for the NHSHC attending GP practices in Southwark, London.

Method: 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.

Results: 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; P<0.001). Regressions found an interaction between intervention and sex (OR = 0.65; 95% CI = 0.44 to 0.86, P = 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.

Conclusion: Prompts on computer systems in general practice were effective at improving the uptake of the NHSHC, especially for males and younger patients.

Original language	English
Pages (from-to)	E693-E700
Number of pages	8
Journal	British Journal of General Practice
Volume	71
Issue number	710
Early online date	13 Jul 2021
DOIs	https://doi.org/10.3399/BJGP.2020.0887
Publication status	Published - Sept 2021

Bibliographical note

Funding Information: This study was funded by Public Health
England.

Open Access:This article is Open Access: CC BY 4.0 licence (https://creativecommons.org/licenses/by/4.0/).

Publisher Copyright: © The Authors.

Citation: Increasing uptake of NHS Health Checks: a randomised controlled trial using GP computer prompts Natalie Gold, Karen Tan, Joseph Sherlock, Robin Watson, Tim Chadborn British Journal of General Practice 2021; 71 (710): e693-e700.

DOI: 10.3399/BJGP.2020.0887

Keywords

Cardiovascular disease
Computer systems
General practice
Primary health care
Primary prevention

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Gold2021IncreasingUptakeOfNHSHealthChecksBrJGenPractFinal published version, 128 KBLicence: CC BY

Cite this

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title = "Increasing uptake of NHS Health Checks: A randomised controlled trial using GP computer prompts",

abstract = "Background: 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. Aim: To assess the effect on uptake of automated prompts to clinical staff to invite patients to NHSHC, delivered via primary care computer systems. Design and setting: Pseudo-randomised controlled trial of patients eligible for the NHSHC attending GP practices in Southwark, London. Method: 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. Results: 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; P<0.001). Regressions found an interaction between intervention and sex (OR = 0.65; 95% CI = 0.44 to 0.86, P = 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. Conclusion: Prompts on computer systems in general practice were effective at improving the uptake of the NHSHC, especially for males and younger patients.",

keywords = "Cardiovascular disease, Computer systems, General practice, Primary health care, Primary prevention",

author = "Natalie Gold and Karen Tan and Joseph Sherlock and Robin Watson and Tim Chadborn",

note = "Funding Information: This study was funded by Public Health England. Open Access:This article is Open Access: CC BY 4.0 licence (https://creativecommons.org/licenses/by/4.0/). Publisher Copyright: {\textcopyright} The Authors. Citation: Increasing uptake of NHS Health Checks: a randomised controlled trial using GP computer prompts Natalie Gold, Karen Tan, Joseph Sherlock, Robin Watson, Tim Chadborn British Journal of General Practice 2021; 71 (710): e693-e700. DOI: 10.3399/BJGP.2020.0887",

year = "2021",

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language = "English",

volume = "71",

pages = "E693--E700",

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T1 - Increasing uptake of NHS Health Checks

T2 - A randomised controlled trial using GP computer prompts

AU - Gold, Natalie

AU - Tan, Karen

AU - Sherlock, Joseph

AU - Watson, Robin

AU - Chadborn, Tim

N1 - Funding Information: This study was funded by Public Health England. Open Access:This article is Open Access: CC BY 4.0 licence (https://creativecommons.org/licenses/by/4.0/). Publisher Copyright: © The Authors. Citation: Increasing uptake of NHS Health Checks: a randomised controlled trial using GP computer prompts Natalie Gold, Karen Tan, Joseph Sherlock, Robin Watson, Tim Chadborn British Journal of General Practice 2021; 71 (710): e693-e700. DOI: 10.3399/BJGP.2020.0887

PY - 2021/9

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N2 - Background: 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. Aim: To assess the effect on uptake of automated prompts to clinical staff to invite patients to NHSHC, delivered via primary care computer systems. Design and setting: Pseudo-randomised controlled trial of patients eligible for the NHSHC attending GP practices in Southwark, London. Method: 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. Results: 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; P<0.001). Regressions found an interaction between intervention and sex (OR = 0.65; 95% CI = 0.44 to 0.86, P = 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. Conclusion: Prompts on computer systems in general practice were effective at improving the uptake of the NHSHC, especially for males and younger patients.

AB - Background: 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. Aim: To assess the effect on uptake of automated prompts to clinical staff to invite patients to NHSHC, delivered via primary care computer systems. Design and setting: Pseudo-randomised controlled trial of patients eligible for the NHSHC attending GP practices in Southwark, London. Method: 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. Results: 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; P<0.001). Regressions found an interaction between intervention and sex (OR = 0.65; 95% CI = 0.44 to 0.86, P = 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. Conclusion: Prompts on computer systems in general practice were effective at improving the uptake of the NHSHC, especially for males and younger patients.

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KW - Computer systems

KW - General practice

KW - Primary health care

KW - Primary prevention

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VL - 71

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JO - British Journal of General Practice

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ER -

Increasing uptake of NHS Health Checks: A randomised controlled trial using GP computer prompts

Abstract

Bibliographical note

Keywords

UN SDGs

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