Development, implementation and yield of a cardiometabolic health check.

BACKGROUND: Cardiometabolic health checks are currently introduced in several countries in an attempt to reduce the population-wide increase of cardiometabolic disease. OBJECTIVE: Developing and implementing a health check for cardiometabolic disorders in a medium-sized primary health care centre and describing the participation rate and the numbers of disorders requiring treatment that are identified. METHODS: Observational research in Eindhoven, The Netherlands. All registered patients aged 40-75 years without known cardiometabolic disease (i.e. cardiovascular diseases, diabetes and chronic kidney disease) (n = 1704) were sent a written invitation to participate in a health check. A three-step procedure was used to determine whether a participant was at increased risk of developing cardiometabolic disease. Treatment was started if necessary, according to current guidelines. We recorded the numbers of patients proceeding through each step and the numbers of disorders identified. RESULTS: A total of 1270 patients (75%) returned the first screening questionnaire. Based on the information from this questionnaire, 952 were invited to visit the health care centre for further assessment. A total of 145 patients (11% of the 1270) were found to have at least one disorder for which treatment was indicated (e.g. increased cardiovascular risk, isolated systolic hypertension, diabetes mellitus, suspected familial hypercholesterolaemia or kidney disease). CONCLUSIONS: The response rate and the number of cases identified demonstrate that cardiometabolic disorders can be effectively detected at a primary health care centre. Further research is needed to assess the long-term effects and efficacy of health checks in general practice.

[Cardiometabolic risk factors detected with a preventative screening programme]. / Cardiometabole risicofactoren opgespoord met preventieconsult.

OBJECTIVE: Design and implementation of a preventative screening programme for cardiometabolic risk assessment in a medium-sized general practice. Description of the response rate and number of detected diseases to be treated. DESIGN: Questionnaire and observational research. METHOD: All registered patients aged 40 to 75 years without prior cardiometabolic disease (cardiovascular diseases, diabetes and renal disorders) (n=1704) received a written invitation to participate in a preventative screening programme. During a maximum of 3 sequential screening steps the risk for cardiometabolic disease for each participant was determined. Based on their outcome, participants were offered treatment when necessary. The number of patients who completed each of the steps as well as the number of detected disorders were registered. RESULTS: In total 1270 patients (75%) returned an initial screening questionnaire. Based on the information provided in this questionnaire 952 patients were invited for an additional examination at the general practice. In 145 participants (11% of 1270) at least one condition was diagnosed that needed either treatment or follow-up according to the prevailing Dutch practice guidelines, such as elevated risk for cardiovascular diseases, isolated systolic hypertension, diabetes mellitus, suspected familiar hypercholesterolaemia or renal disorders. CONCLUSION: The response-rate as well as the number of newly diagnosed cases demonstrate that it is quite feasible to screen for cardiometabolic disorders in a primary healthcare centre. Follow-up studies are needed to assess the long-term health effects and efficiency of the preventative screening programme.