Scottish Keep Well health check programme: an interrupted time series analysis

摘要: Background Effective interventions are available to reduce cardiovascular risk. Recently, health check programmes have been implemented target those at high risk of disease (CVD), but there is much debate whether these likely be effective population level. This paper evaluates the impact wave 1 Keep Well, a Scottish programme, on outcomes. Methods Interrupted time series analyses were employed, comparing trends in outcomes participating and non-participating practices before after introduction checks. Health defined as CVD mortality, incident hospitalisations prescribing drugs. Results After accounting for secular seasonal variation, coronary heart mortality changed by 0.4% (95% CI −5.2% 6.3%) −1.1% (−3.4% 1.3%) Well −0.3% (−2.7% 2.2%) −0.1% (−1.8% 1.7%) non-Keep practices, respectively, following intervention. Adjusted changes (−10.4% 12.5%) −1.5% (−9.4% 7.2%) statins; −2.5% (−12.3% 8.4%) −1.6% (−7.1% 4.3%) antihypertensive drugs; −0.9% (−6.5% 5.0%) −2.4% (−10.1% 6.0%) antiplatelet Conclusions Any intervention Scotland was very small. Findings do not support use screening approach used current address CVD. We an interrupted method, evaluation methods based randomisation feasible preferable would allowed more reliable conclusions. These should considered often policymakers early stage programme design when uncertainty regarding effectiveness.