London | Intelligence-led heart disease prevention can significantly increase the prescription of preventive drugs to patients instead of the current programme run by the UK’s National Health Service for all adults over 40, according to a new research.
The findings, published in the ‘British Journal of General Practice’, present a strategy that could address the under- treatment of individuals at highest risk of heart disease or stroke.
“We know that the treatments work. The problem has been identifying the highest-risk patients who benefit most and offering them blood pressure treatment or statins,” Professor Tom Marshall from the University of Birmingham said.
According to authors, it presents clear evidence that using electronic medical records to target patients for health checks is a better solution than the official UK policy of health checks for all adults due to their inability to identify enough high risk eligible patients or to start enough preventive drugs in patients who need them.
This study took place in 26 general practices from urban areas in the West Midlands region of the UK between February 2009 and August 2012.
Untreated high-risk patients between the ages of 35-74 were identified from their GP’s electronic medical records.
A high-risk patient community is defined by at least 20 in 100 being expected to get heart disease within the next 10 years. Most of the identified group were middle-aged males, and around half were smokers.
The study compared the number of patients started on preventive drugs when the nurse was actively inviting patients to the number started in a similar time period before the nurse arrived.
Of the 2,926 high-risk patients identified when the nurse was working in the practice, 19.7 per cent were started on treatment. Before the nurse arrived, there were 2,969 high- risk patients, similar in age and sex, but only 10.8 per cent were started on treatment.
Official UK government policy is to offer NHS health checks to everybody aged over 40 years.
A group of general practices were provided with a list of high-risk patients, but not one was invited for assessment, suggesting that simply providing a list of high-risk patients to general practice would not be enough.
“Health checks may be wasteful because it does not prioritise those most likely to benefit. We now have strong evidence to support the idea of targeted health checks. It is a bit like intelligence-led policing, putting our staff where they are most likely to be useful,” Prof Marshall said.