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

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

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Natalie Gold

Karen Tan

Joseph Sherlock

Robin Watson
PGR Student Doctor of Philosophy

Tim Chadborn


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.

Journal Article Type Article
Acceptance Date Apr 13, 2021
Online Publication Date Aug 26, 2021
Publication Date 2021-09
Deposit Date Oct 14, 2021
Publicly Available Date Oct 14, 2021
Journal British Journal of General Practice
Print ISSN 0960-1643
Electronic ISSN 1478-5242
Publisher Royal College of General Practitioners
Peer Reviewed Peer Reviewed
Volume 71
Issue 710
Article Number e693
Public URL


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