title: Reasons for (non)compliance with intervention following identification of 'high-risk' status in the NHS Health Check programme.
abstract: BACKGROUND
  The Department of Health introduced a risk assessment, management and reduction programme, NHS Health Checks, which aimed to reduce premature morbidity and mortality from cardiovascular diseases for those aged 40-74. Those identified as at increased risk of CVD are offered prophylactic medication and lifestyle advice to reduce their risk. Health gains will only be achieved if patients are compliant with advice/intervention however. This study sought to understand factors that influenced adherence to medication and advice in 'high-risk' patients.
  
  
  METHODS
  Qualitative data were collected through 29 semi-structured interviews with a purposive sample of individuals who had been identified as at high-risk of CVD. Participants had been offered lifestyle advice, lipid lowering medications and attended at least one annual review.
  
  
  RESULTS
  Findings explore the challenges and experiences confronting 'high-risk' individuals when making decisions about engaging with intervention. Key findings explore: statin adherence, as well as adherence to advice about diet, physical activity, alcohol consumption and smoking cessation.
  
  
  CONCLUSIONS
  Attention needs to be paid to the way prophylactic medications are prescribed and explained to high-risk patients. Consistent provision of tailored lifestyle advice and access to appropriate services could facilitate sustained changes to factors that increase CVD risk.
authors.affiliation: School of Health and Care, Health and Social Care Institute, Teesside University, Middlesbrough TS1 3BA, UK Fuse (UKCRC Centre for Translational Research in Public Health), Newcastle University, Newcastle-upon-Tyne NE2 4AX, UK.
authors.forename: R J
authors.initials: RJ
authors.lastname: McNaughton
authors.affiliation: School of Health and Care, Health and Social Care Institute, Teesside University, Middlesbrough TS1 3BA, UK Fuse (UKCRC Centre for Translational Research in Public Health), Newcastle University, Newcastle-upon-Tyne NE2 4AX, UK.
authors.forename: J
authors.initials: J
authors.lastname: Shucksmith
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D004739:England / Q000453:epidemiology; D005260:Female; D006291:Health Policy; D006292:Health Priorities; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D007407:Interviews as Topic; D008019:Life Style; D008297:Male; D008403:Mass Screening / Q000458:organization & administration*; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D015980:Public Health Practice; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care; D018570:Risk Assessment; D013222:State Medicine / Q000458:organization & administration*
chemical_list: D000960:Hypolipidemic Agents
keywords: health services; public health; screening