Secondary healthcare contacts after multiphasic preventive health screening: a randomized trial.

AIM: To analyze the consequence of preventive health screenings and discussions on the utilization of secondary healthcare. METHODS: All 30- to 49-year-old residents registered with a general practitioner in the district of Ebeltoft, Denmark, were included (n = 3,464) in a randomized controlled trial with eight years' follow-up. A random sample of 2,030 subjects was selected for invitation (Invited). The remaining 1,434 persons were never contacted and served as external control group (Non-Invited). Persons accepting participation were randomly divided into one internal control group (Questionnaire) and two intervention groups. One intervention group was offered three health screenings (Health Screening) during the five years. The other intervention group were in addition offered a yearly health discussion with their general practitioner (Health Screening and Discussion). RESULTS: The rate ratio for hospital admissions was 0.97 (95% confidence interval 0.80 to 1.18) in the Invited group compared with the Non-Invited. The annual admission rates showed a significant trend (p = 0.0003) with a decrease four and five years after intervention launch for the Invited group compared with the Non-Invited. A similar trend was found when comparing the internal control group with intervention groups (p = 0.0016). CONCLUSIONS: A 30- to 49-year-old general population's utilization of secondary healthcare did not increase in response to a general health promotion offer. During the observation period a significant decline in annual hospital admission rates was seen.

Adverse social factors predict early ageing in middle-aged men and women: the Ebeltoft Health Study, Denmark.

AIMS: This study examined whether adverse social factors are associated with an increased rate of biological ageing in middle-aged subjects. METHODS: The authors investigated five markers of biological ageing in 690 subjects followed for five years in Ebeltoft, Denmark. Mean age at baseline was 40 years (range 30-50 years). These markers included repeated measures of pulse pressure, lung function, hearing, physical work capacity and a cardiovascular risk score. A zeta-score was calculated based on a factor analysis of the five markers used. The relative biological age was finally calculated in relation to chronological age in subgroups of different social class (occupation, educational level) and marital status, at baseline and after follow-up. RESULTS: Men and women from a higher social class appeared to be biologically younger than corresponding subjects from a lower social class (p < 0.001). This difference was still evident after 5 years of follow-up (p < 0.01) for men and women of different occupations and for women of different educational levels (p < 0.01). Married/cohabiting men were biologically younger than single men and this difference increased during the follow-up period in that the difference between groups at five-year follow-up was significant (p < 0.05). CONCLUSIONS: Middle-aged men and women from a higher social class showed signs of being biologically younger than their corresponding chronological age, while the opposite was found for men and women of lower social class. This discrepancy was still evident after five years of follow-up, and even tended to increase for single men. Differential ageing may thus be an important biological aspect of differences in health according to social class.

[Can systematic general health screening and patient-physician health discussions improve the cardiovascular profile of the population? A randomized controlled trial in general practice with a 5-year follow-up]. / Kan systematiske generelle helbredsundersøgelser og helbredssamtaler forbedre den kardiovaskulaere risikoprofil i befolkningen? En randomiseret og kontrolleret undersøgelse i almen praksis med fem års opfølgning.

INTRODUCTION: We investigated the impact of general health screenings and discussions with general practitioners on the cardiovascular risk profile of the population. MATERIAL AND METHODS: A population-based, randomised, controlled, 5-year follow-up trial conducted in a primary care setting. In total 2000 randomly selected men and women, aged 30-50 years, from family practices in the district of Ebeltoft, Denmark. Of these persons, 1507 (75.4%) agreed to participate, and were randomised into: (1) a control group who did not receive health screenings; (2) an intervention group that received two health screenings; or (3) an intervention group that received both the two screenings and a 45-minute follow-up consultation annually with their general practitioner. All were followed up after 5 years by questionnaires and health screenings. The outcome measures were: cardiovascular risk score (CRS), body mass index (BMI), blood pressure, serum cholesterol, carbon monoxide in expiratory air, and use of tobacco. RESULTS: After 5 years, the CRS, BMI, and serum cholesterol levels were lower in the intervention groups, as compared with the control group. The improved outcome was greater in the baseline risk groups. The number of persons with elevated CRS in the intervention groups was about half the number of persons with elevated CRS in the control group. The difference was not a result of medication use. There was no difference between the group that received consultations after the screenings and the group that had health screenings alone. DISCUSSION: Systematic health screenings reduce the cardiovascular risk score in a middle-aged population. After 5 years of follow-up, the number of persons at elevated cardiovascular risk was about half the expected. The impact of intervention is higher in at-risk individuals. Planned consultations about health did not appear to improve the cardiovascular profile of the study population.

General health screenings to improve cardiovascular risk profiles: a randomized controlled trial in general practice with 5-year follow-up.

OBJECTIVES: To investigate the impact of general health screenings and discussions with general practitioners on the cardiovascular risk profile of a random population of patients. STUDY DESIGN: A population-based, randomized, controlled, 5-year follow-up trial conducted in a primary care setting. POPULATION: The study group consisted of 2000 patients, randomly selected middle-aged men and women aged 30 to 50 years from family practices in the district of Ebeltoft, Denmark. Of these patients, 1507 (75.4%) agreed to participate. Patients were randomized into (1) a control group who did not receive health screenings, (2) an intervention group that received 2 health screenings, (3) an intervention group that received both the 2 screenings and a 45-minute follow-up consultation annually with their general practitioner. OUTCOMES MEASURED: Cardiovascular risk score (CRS), body mass index (BMI), blood pressure, serum cholesterol, carbon monoxide in expiratory air, and tobacco use. RESULTS: After 5 years, the CRS, BMI, and serum cholesterol levels were lower in the intervention groups compared with the control group. The improved outcome was greater in the baseline risk groups. The number of patients with elevated CRS in the intervention groups was approximately half the number of patients with elevated CRS in the control group. The difference was not a result of medication use. There was no difference between the group that received consultations after the screenings and the group that had health screenings alone. CONCLUSIONS: Health screenings reduced the CRS in the intervention groups. After 5 years of follow-up, the number of persons at elevated cardiovascular risk was about half that expected, based on the prevalence/proportion in a population not receiving the health checks (the control group). The impact of intervention was higher among at-risk individuals. Consultations about health did not appear to improve the cardiovascular profile of the study population.