Cardiovascular disease risk communication in NHS Health Checks: a qualitative video-stimulated recall interview study with practitioners

Abstract

BackgroundNHS Health Check (NHSHC) is a national programme to identify and manage cardiovascular disease (CVD) risk. Practitioners delivering the programme should be competent in discussing CVD risk, but there is evidence of limited understanding of the recommended 10 year/centage CVD risk scores. Lifetime CVD risk calculators might improve understanding and communication of risk.AimTo explore practitioner understanding, perceptions and experiences of CVD risk communication in NHSHCs when using two different CVD risk calculators.Design & settingQualitative video-stimulated recall (VSR) study with NHSHC practitioners.MethodVSR interviews were conducted with practitioners who delivered NHSHCs using either the QRISK2 10-year risk calculator (n=7) or JBS3 lifetime CVD risk calculator (n=8). Data were analysed using reflexive thematic analysis.ResultsFindings from analysis of VSR interviews with 15 practitioners (9 Healthcare Assistants, 6 General Practice Nurses) are presented by risk calculator. There was limited understanding and confidence of 10-year risk, which was used to guide clinical decisions through determining low/medium/high risk thresholds, rather than as a risk communication tool. Potential benefits of some JBS functions were evident, particularly heart age, risk manipulation and visual presentation of risk.ConclusionsThere is a gap between the expectation and reality of practitioners’ understanding, competencies and training in CVD risk communication for NHS Health Check. Practitioners would welcome heart age and risk manipulation functions of JBS3 to promote patient understanding of CVD risk, but there is a more fundamental need for practitioner training in CVD risk communication.

NHS Health Check programme: a rapid review update

“… 53 Another new study found that practitioners often demonstrated limited understanding and confidence in explaining the 10-year risk score to patients, whereas confidence in the JBS3 lifetime CVD risk calculator, with its visual information summaries, was higher. 54 …”

“…A newly retrieved study reported that overall fidelity of delivery of NHS-HCs in general practice was high, however, important elements of the NHS-HC, including assessments in relation to ethnicity and family history of disease, in addition to the Alcohol Use Disorders Identification Test and dementia risk management, were being regularly omitted 53. Another new study found that practitioners often demonstrated limited understanding and confidence in explaining the 10-year risk score to patients, whereas confidence in the JBS3 lifetime CVD risk calculator, with its visual information summaries, was higher 54…”

“…53 Another new study found that practitioners often demonstrated limited understanding and confidence in explaining the 10-year risk score to patients, whereas confidence in the JBS3 lifetime Open access CVD risk calculator, with its visual information summaries, was higher. 54 Objective 5: patient views on the NHS-HC programme Overall patient satisfaction levels with the programme were high, however the risk score was less helpful to patients than discussion about their health with the clinician during the NHS-HC. Although more recent research suggests that visual representations of CVD risk were more easily understood than a percentage risk score.…”

Cardiovascular disease risk communication in NHS Health Checks using QRISK®2 and JBS3 risk calculators: the RICO qualitative and quantitative study

“…Chapter 6 Results 4: video-stimulated recall interviewspractitioners P arts of this chapter have been reproduced with permission from Gidlow et al 75 This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: https://creativecommons.org/licenses/ by/4.0/.…”

What factors influence differential uptake of NHS Health Checks, diabetes and hypertension reviews among women in ethnically diverse South London? Cross-sectional analysis of 63,000 primary care records

“… 16 However, challenges remain in understanding, competencies, and training in CVD risk communication for NHS health checks carried out by healthcare professionals. 17 …”