Implementation of the NHS Health Checks programme: baseline assessment of risk factor recording in an urban culturally diverse setting.
BACKGROUND
National Health Service (NHS) Health Checks, a population-wide prevention programme introduced during 2009, aims to measure and manage cardiovascular disease (CVD) risk factors among all persons aged 40-74 years in England. The potential workload implications of the programme for general practice are considerable, particularly in deprived culturally diverse settings.


OBJECTIVE
To examine the baseline levels of CVD risk factor recording in general practices located in Ealing, North West London.


METHODS
Cross-sectional study using data extracted from electronic medical records in 14 general practices between December 2008 and January 2009. The completeness of blood pressure, smoking, body mass index (BMI) and cholesterol recording was examined by practice and patient characteristics.


RESULTS
Recording of blood pressure [85.6% (practice interquartile range = 10.1)] and smoking status [95.8% (2.6)] was very high in practices. Recording of BMI [72.8% (23.4)] and cholesterol [55.6% (25.3)] was considerably lower. There were large differences in recording between practices (range for cholesterol: 33.6-78.0%), though these were largely explained by patient characteristics. In regression analysis, hypertensive patients [adjusted odds ratio (AOR) = 36.3, 95% confidence interval (CI) 21.0-62.9], women [AOR = 2.88 (95% CI 2.64-3.15)] and older patients [AOR = 2.75 (95% CI 2.28-3.32) for 65-74 against 35-44 years of age] had better recording of blood pressure as well as BMI and cholesterol. Recording of blood pressure [AOR = 1.38 (95% CI 1.09-1.75)] and cholesterol [AOR = 1.47 (95% CI 1.30-1.66)] was significantly higher among South Asian patients.


CONCLUSIONS
The workload implications of the NHS Health Checks programme for general practices in England are substantial. There are considerable variations in risk factor recording between practices and between age, gender and ethnic groups.
Dalton
Andrew R H
AR
Department of Primary Care and Public Health, Imperial College Faculty of Medicine, St. Dunstan's Road, London, UK. andrew.dalton07@imperial.ac.uk
Bottle
Alex
A
Okoro
Cyprian
C
Majeed
Azeem
A
Millett
Christopher
C
D000328:Adult; D000368:Aged; D001795:Blood Pressure Determination; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D002784:Cholesterol / Q000097:blood; D003376:Counseling; D003430:Cross-Sectional Studies; D018864:Cultural Diversity; D005260:Female; D058006:General Practice / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D008131:London; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention / Q000379:methods*; D018570:Risk Assessment / Q000379:methods; D012959:Socioeconomic Factors; D013222:State Medicine
D002784:Cholesterol