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首页> 外文期刊>BMC Public Health >Randomised controlled trial comparing uptake of NHS Health Check in response to standard letters, risk-personalised letters and telephone invitations
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Randomised controlled trial comparing uptake of NHS Health Check in response to standard letters, risk-personalised letters and telephone invitations

机译：随机对照试验比较NHS健康检查的摄取响应标准字母，风险个性化字母和电话邀请函

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NHS Health Check is a primary prevention programme offering cardiovascular disease (CVD) risk assessment to adults in England aged 40-74. Uptake remains a challenge and invitation method is a strong predictor of uptake. There is evidence of low uptake when using invitation letters. Telephone invitations might increase uptake, but are not widely used. We explored the potential to improve uptake through personalising letters to patient's CVD risk, and to compare this with generic letters and telephone invitations. HEalth Check TRial (HECTR) was a three-arm randomised controlled trial in nine general practices in Staffordshire (UK). Eligible patients were randomised to be invited to a NHS Health Check using one of three methods: standard letter (control); telephone invitation; letter personalised to the patient's CVD risk. The primary outcome was attendance/non-attendance. Data were collected on a range of patient- and practice-level factors (e.g., patient socio-demographics, CVD risk, practice size, Health Checks outside usual working hours). Multi-level logistic regression estimated the marginal effects to explore whether invitation method predicted attendance. Invitation costs were collated from practices to estimate cost benefit. In total, 4614 patients were included in analysis (mean age 50.2?±?8.0?yr.; 52.4% female). Compared with patients invited by standard letter (30.9%), uptake was significantly higher in those invited by telephone (47.6%, P??.001), but not personalised letter (31.3%, p?=?.812). In multi-level analysis, compared with the standard letter arm, likelihood of attendance was 18 percentage points higher in the telephone arm and 4 percentage points higher in the personalised letter arm. The effect of telephone calls appeared strongest in patients who were younger and had lower CVD risk. We estimated per 1000 patients invited, risk-personalised letters could result in 40 additional attended Health Checks (at no extra cost) and telephone invitations could result in 180 additional Health Checks at an additional cost of ￡240. Telephone invitations should be advocated to address the substantial deficit between current and required levels of NHS uptake, and could be targeted at younger and lower CVD risk adults. Risk-personalised letters should be explored further in a larger sample of high risk individuals. Registration number: ISRCTN15840751 date of registration: 24/10/2017.
机译：NHS Health Check是一项主要预防计划，为40-74岁的英格兰的成人提供心血管疾病（CVD）风险评估。摄取仍然是一个挑战，邀请方法是一种强烈的摄取预测因素。使用邀请字母时存在低吸收的证据。电话邀请可能会增加摄取，但没有被广泛使用。我们探讨了通过对患者的CVD风险的个性化，并将其与通用信件和电话邀请进行比较。卫生检查试验（大楼）是斯塔福德郡（英国）的九个一般实践中的三臂随机对照试验。使用三种方法之一进行随机邀请符合条件的患者进行NHS健康检查：标准信（控制）;电话邀请;以患者的CVD风险个性化的信件。主要结果是出席/非出勤率。收集数据的一系列患者和实践级别因素（例如，患者社会人口统计数据，CVD风险，实践规模，常用工作时间外的健康检查）。多级逻辑回归估计探索邀请方法是否预测出席的边际效应。邀请成本从估计成本效益的实践中。总共包括4614名患者分析（平均50.2°（±8.0°）; 52.4％的女性）。与标准信（30.9％）邀请的患者相比，通过电话邀请的人（47.6％，P？<001），但不是个性化的字母（31.3％，P？=Δ..812）。在多级分析中，与标准字母臂相比，电话手臂的出勤可能性高出18个百分点，个性字母臂中的4个百分点高。电话呼叫的效果在年轻的患者中出现最强，并且具有较低的CVD风险。我们估计每1000名患者邀请，风险个性化的信件可能导致40次出席的卫生检查（无需额外费用），电话邀请可能导致180个额外的健康检查，额外费用为240英镑。应提倡电话邀请函，以解决当前和所需水平的NHS摄取程度之间的大量赤字，并且可以针对年轻人和降低的CVD风险成年人。应在更大的高风险性上进一步探讨风险个性化信。注册号：ISRCTN15840751日期（注册）：2017/0/2017。

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