Health promotion in primary care: modelling the impact of intervention on coronary heart disease and stroke.
BACKGROUND
Since the health promotion programme for general practice was introduced in 1993, there has been some controversy about the potential effectiveness and likely cost-effectiveness of health promotion in general practice. The aim of this study was to generate a model to estimate the potential impact of the new general practice health promotion programme on coronary heart disease (CHD) and stroke, in terms of absolute reductions in mortality, in Cambridge Health Authority, a district with relatively low mortality rates for these two diseases.


METHODS
A model to estimate the impact of the programme was derived from local data for risk factor prevalence in men and women aged 45-74; local death rates for CHD and stroke; and published data on the effectiveness of general practice health promotion.


RESULTS
The expected number of deaths in the ten years following screening was estimated at 3203 deaths for CHD and 1075 for stroke. The model estimates a 12% reduction in CHD deaths and 17% fewer stroke deaths following the implementation of the programme.


CONCLUSIONS
Even in areas where risk factor prevalence is low and death rates are low, the health promotion programme has the potential to have a moderate impact on CHD and stroke mortality. The cost-effectiveness of the programme, however, has yet to be established.
Pharoah
P D
PD
Cambridge and Huntingdon Health Commission, Fulbourn Hospital.
Sanderson
S P
SP
D000368:Aged; D002561:Cerebrovascular Disorders / Q000401:mortality / Q000517:prevention & control*; D002784:Cholesterol / Q000097:blood; D003327:Coronary Disease / Q000401:mortality / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D004739:England / Q000453:epidemiology; D005194:Family Practice; D005260:Female; D006293:Health Promotion / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D012307:Risk Factors; D016540:Smoking Cessation
D002784:Cholesterol