Quantitative examination of video-recorded NHS Health Checks: comparison of the use of QRISK2 versus JBS3 cardiovascular risk calculators
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Objectives Quantitatively examine the content of National Health Service Health Check (NHSHC), patient–practitioner communication balance and differences when using QRISK2 versus JBS3 cardiovascular disease (CVD) risk calculators. Design RIsk COmmunication in NHSHC was a qualitative study with quantitative process evaluation, comparing NHSHC using QRISK2 or JBS3. We present data from the quantitative process evaluation. Setting and participants Twelve general practices in the West Midlands (England) conducted NHSHC using JBS3 or QRISK2 (6/group). Patients were eligible for NHSHC based on national criteria (aged 40–74, no existing cardiovascular-related diagnoses, not taking statins). Recruitment was stratified by patients’ age, gender and ethnicity. Methods Video recordings of NHSHC were coded, second-by-second, to quantify who was speaking and what was being discussed. Outcomes included consultation duration, practitioner verbal dominance (ratio of practitioner:patient speaking time (pr:pt ratio)) and proportion of time discussing CVD risk, risk factors and risk management. Results 173 video-recorded NHSHC were analysed (73 QRISK, 100 JBS3). The sample was 51% women, 83% white British, with approximately equal proportions across age groups. NHSHC duration varied greatly (6.8–38.0 min). Most (60%) lasted less than 20 min. On average, CVD risk was discussed for less than 2 min (9.06%±4.30% of consultation time). There were indications that, compared with NHSHC using JBS3, those with QRISK2 involved less CVD risk discussion (JBS3 M=10.24%, CI: 8.01–12.48 vs QRISK2 M=7.44%, CI: 5.29–9.58) and were more verbally dominated by practitioners (pr:pt ratio JBS3 M=3.21%, CI: 2.44–3.97 vs QRISK2=2.35%, CI: 1.89–2.81). The largest proportion of NHSHC time was spent discussing causal risk factors (M=37.54%, CI: 32.92–42.17). Conclusions There was wide variation in NHSHC duration. Many were short and practitioner-dominated, with little time discussing CVD risk. JBS3 appears to extend CVD risk discussion and patient contribution. Qualitative examination of how it is used is necessary to fully understand the potential benefits of these differences.
Gidlow, C.J., Ellis, N.J., Cowap, L., Riley, V.A., Crone, D., Cottrell, E., Grogan, S., Chambers, R. and Clark-Carter, D. (2020) Quantitative examination of video-recorded NHS Health Checks: comparison of the use of QRISK2 versus JBS3 cardiovascular risk calculators. BMJ open, 10(9), p.e037790.
Dynodwr Gwrthrych Digidol (DOI)http://dx.doi.org/10.1136/bmjopen-2020-037790
Article published in BMJ Open available open access at http://dx.doi.org/10.1136/bmjopen-2020-037790
Cardiff Metropolitan University (Grant ID: Cardiff Metropolian (Internal))
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A qualitative study of cardiovascular disease risk communication in NHS Health Check using different risk calculators: protocol for the RIsk COmmunication in NHS Health Check (RICO) study. BMC family practice, 20(1), 11. Gidlow, C; Ellis, N.J.; Cowap, L; Riley, V; Crone, Diane; Cottrell, E; Grogan, S; Chambers, R; Clark-Carter, D (Springer, 2019-01-14)Background NHS Health Check is a national cardiovascular disease (CVD) risk assessment programme for 40–74 year olds in England, in which practitioners should assess and communicate CVD risk, supported by appropriate ...
A Qualitative Exploration of Two Risk Calculators Using Video-Recorded NHS Health Check Consultations Riley, Victoria; Ellis, Naomi J.; Cowap, Lisa; Grogan, Sarah; Cottrell, Elizabeth; Crone, Diane; Chambers, Ruth; Clark-Carter, David; Federowicz, Sophia; Gidlow, Christopher J. (Springer, 2020-12-03)Background: The aim of the study was to explore practitioner-patient interactions and patient responses when using QRISK®2 or JBS3 cardiovascular disease (CVD) risk calculators. Data were from video-recorded NHS Health ...
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