Quantitative examination of video-recorded NHS Health Checks: comparison of the use of QRISK2 versus JBS3 cardiovascular risk calculators
Objectives Quantitatively examine the content of National Health Service Health Check (NHSHC), patient–practitioner communication balance and differences when using QRISK2 versus JBS3 cardiovascular disease (CVD) risk calculators.Design RIsk COmmunication in NHSHC was a qualitative study with quanti...
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| Format: | Article |
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BMJ Publishing Group
2020-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/9/e037790.full |
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| author | Christopher J Gidlow Sarah Grogan Lisa Cowap Elizabeth Cottrell Ruth Chambers Naomi J Ellis Victoria A Riley Diane Crone David Clark-Carter |
| author_facet | Christopher J Gidlow Sarah Grogan Lisa Cowap Elizabeth Cottrell Ruth Chambers Naomi J Ellis Victoria A Riley Diane Crone David Clark-Carter |
| author_sort | Christopher J Gidlow |
| collection | DOAJ |
| description | Objectives Quantitatively examine the content of National Health Service Health Check (NHSHC), patient–practitioner communication balance and differences when using QRISK2 versus JBS3 cardiovascular disease (CVD) risk calculators.Design RIsk COmmunication in NHSHC was a qualitative study with quantitative process evaluation, comparing NHSHC using QRISK2 or JBS3. We present data from the quantitative process evaluation.Setting and participants Twelve general practices in the West Midlands (England) conducted NHSHC using JBS3 or QRISK2 (6/group). Patients were eligible for NHSHC based on national criteria (aged 40–74, no existing cardiovascular-related diagnoses, not taking statins). Recruitment was stratified by patients’ age, gender and ethnicity.Methods Video recordings of NHSHC were coded, second-by-second, to quantify who was speaking and what was being discussed. Outcomes included consultation duration, practitioner verbal dominance (ratio of practitioner:patient speaking time (pr:pt ratio)) and proportion of time discussing CVD risk, risk factors and risk management.Results 173 video-recorded NHSHC were analysed (73 QRISK, 100 JBS3). The sample was 51% women, 83% white British, with approximately equal proportions across age groups. NHSHC duration varied greatly (6.8–38.0 min). Most (60%) lasted less than 20 min. On average, CVD risk was discussed for less than 2 min (9.06%±4.30% of consultation time). There were indications that, compared with NHSHC using JBS3, those with QRISK2 involved less CVD risk discussion (JBS3 M=10.24%, CI: 8.01–12.48 vs QRISK2 M=7.44%, CI: 5.29–9.58) and were more verbally dominated by practitioners (pr:pt ratio JBS3 M=3.21%, CI: 2.44–3.97 vs QRISK2=2.35%, CI: 1.89–2.81). The largest proportion of NHSHC time was spent discussing causal risk factors (M=37.54%, CI: 32.92–42.17).Conclusions There was wide variation in NHSHC duration. Many were short and practitioner-dominated, with little time discussing CVD risk. JBS3 appears to extend CVD risk discussion and patient contribution. Qualitative examination of how it is used is necessary to fully understand the potential benefits of these differences.Trial registration number ISRCTN10443908. |
| format | Article |
| id | doaj-art-6b907b86d2c8481fafc2bc18fa813991 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-6b907b86d2c8481fafc2bc18fa8139912025-01-08T06:35:10ZengBMJ Publishing GroupBMJ Open2044-60552020-09-0110910.1136/bmjopen-2020-037790Quantitative examination of video-recorded NHS Health Checks: comparison of the use of QRISK2 versus JBS3 cardiovascular risk calculatorsChristopher J Gidlow0Sarah Grogan1Lisa Cowap2Elizabeth Cottrell3Ruth Chambers4Naomi J Ellis5Victoria A Riley6Diane Crone7David Clark-Carter8Centre for Health and Development, Staffordshire University, Stoke-on-Trent, UK2 Department of Psychology, Manchester Metropolitan University, Manchester, UK3 Faculty of Health Sciences, Staffordshire University, Staffordshire, UKSchool of Medicine, Keele University, Keele, UKStoke-on-Trent Clinical Commissioning Group, Stoke on Trent, UKFaculty of Health Sciences, Staffordshire University, Stoke-on-Trent, UKCentre for Health and Development, Staffordshire University, Stoke-on-Trent, UKCardiff Metropolitan University, Cardiff, UKDepartment of Psychology, Staffordshire University, Stoke on Trent, UKObjectives Quantitatively examine the content of National Health Service Health Check (NHSHC), patient–practitioner communication balance and differences when using QRISK2 versus JBS3 cardiovascular disease (CVD) risk calculators.Design RIsk COmmunication in NHSHC was a qualitative study with quantitative process evaluation, comparing NHSHC using QRISK2 or JBS3. We present data from the quantitative process evaluation.Setting and participants Twelve general practices in the West Midlands (England) conducted NHSHC using JBS3 or QRISK2 (6/group). Patients were eligible for NHSHC based on national criteria (aged 40–74, no existing cardiovascular-related diagnoses, not taking statins). Recruitment was stratified by patients’ age, gender and ethnicity.Methods Video recordings of NHSHC were coded, second-by-second, to quantify who was speaking and what was being discussed. Outcomes included consultation duration, practitioner verbal dominance (ratio of practitioner:patient speaking time (pr:pt ratio)) and proportion of time discussing CVD risk, risk factors and risk management.Results 173 video-recorded NHSHC were analysed (73 QRISK, 100 JBS3). The sample was 51% women, 83% white British, with approximately equal proportions across age groups. NHSHC duration varied greatly (6.8–38.0 min). Most (60%) lasted less than 20 min. On average, CVD risk was discussed for less than 2 min (9.06%±4.30% of consultation time). There were indications that, compared with NHSHC using JBS3, those with QRISK2 involved less CVD risk discussion (JBS3 M=10.24%, CI: 8.01–12.48 vs QRISK2 M=7.44%, CI: 5.29–9.58) and were more verbally dominated by practitioners (pr:pt ratio JBS3 M=3.21%, CI: 2.44–3.97 vs QRISK2=2.35%, CI: 1.89–2.81). The largest proportion of NHSHC time was spent discussing causal risk factors (M=37.54%, CI: 32.92–42.17).Conclusions There was wide variation in NHSHC duration. Many were short and practitioner-dominated, with little time discussing CVD risk. JBS3 appears to extend CVD risk discussion and patient contribution. Qualitative examination of how it is used is necessary to fully understand the potential benefits of these differences.Trial registration number ISRCTN10443908.https://bmjopen.bmj.com/content/10/9/e037790.full |
| spellingShingle | Christopher J Gidlow Sarah Grogan Lisa Cowap Elizabeth Cottrell Ruth Chambers Naomi J Ellis Victoria A Riley Diane Crone David Clark-Carter Quantitative examination of video-recorded NHS Health Checks: comparison of the use of QRISK2 versus JBS3 cardiovascular risk calculators BMJ Open |
| title | Quantitative examination of video-recorded NHS Health Checks: comparison of the use of QRISK2 versus JBS3 cardiovascular risk calculators |
| title_full | Quantitative examination of video-recorded NHS Health Checks: comparison of the use of QRISK2 versus JBS3 cardiovascular risk calculators |
| title_fullStr | Quantitative examination of video-recorded NHS Health Checks: comparison of the use of QRISK2 versus JBS3 cardiovascular risk calculators |
| title_full_unstemmed | Quantitative examination of video-recorded NHS Health Checks: comparison of the use of QRISK2 versus JBS3 cardiovascular risk calculators |
| title_short | Quantitative examination of video-recorded NHS Health Checks: comparison of the use of QRISK2 versus JBS3 cardiovascular risk calculators |
| title_sort | quantitative examination of video recorded nhs health checks comparison of the use of qrisk2 versus jbs3 cardiovascular risk calculators |
| url | https://bmjopen.bmj.com/content/10/9/e037790.full |
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