This study evaluated NHS Health Checks implemented in a community pharmacy in England. The pharmacy provided health checks to eligible patients aged 40-74 over 2 years. A subset of patients received a follow up check about 1 year later. Initial health checks identified high cardiovascular risk in many patients, with 48% referred for issues like high blood pressure. Follow up checks on 52 patients found small but statistically significant reductions in cardiovascular risk scores after 1 year, suggesting community pharmacies can help improve risk factors long term. The study concludes community pharmacies can effectively contribute to health check targets and identify at-risk patients for referral, but more research is needed on their ability to impact long term outcomes.

1. An evaluation of NHS Health Checks in
community pharmacy;
changes in cardiovascular risk factors over
one year in patients aged 40-74
SJ Butterworth
SC Willis
P Higginson
Manchester Pharmacy School
The University of Manchester

2. NHS Health Check
• Cardiovascular risk assessment
• Provided in the English National Health Service
• Population aged 40-74 without recognised
cardiovascular disease
– Assess cardiovascular risk factors
– Calculate cardiovascular risk (QRisk2-12)
– Convey risk to user in a way they can understand
– Provide supporting lifestyle advice

4. AIMS

5. • Evaluate the implementation of NHS Health
Checks in a community pharmacy by comparing
against national standards and targets
• Investigate the outcomes of intervention by
reassessing a sample of patients after a period
of around one year.

6. METHOD

7. Study design
• Single community pharmacy in a rural setting in
England
• Initial Health Checks on eligible population (from
December 2012-June 2014)
• Follow up after about 1 year on a subset of that
population (invited sequentially to return up to a
minimum of 50)

9. RESULTS

10. Can community pharmacy in
non-urban settings effectively
contribute to targets for the
proportion of Health Checks
completed?

11. England Cumbria LSOA 007
Number Eligible 15,308,022 167,367 586
Number Offered 2,824,426
(18.5%)
40,142 (24.0%) N/A
Number Received 1,382,864 (9.0%) 18,276 (10.9%) 139 (23.7%)

12. To what extent do Health
Checks completed in
community pharmacy meet
recognised quality
standards?

13. Public Health England Standards for
Health Checks

14. What are the outcomes of
health checks completed in
community pharmacy either
through measurable
changes over 12 months or
through referral?

15. Initial cohort results
• 161 participants, mean age 57.5 (95% CI 56.0-
58.7)
– 98 female (60.9%) mean age 57.3 (CI 55.6-59.0)
– 63 male (39.1%) mean age 57.5 (CI 55.2-59.7)
• Mean 10 year CVD Risk 9.3% (CI 8.2-10.5)
– Male CVD Risk 12.9%
– Female CVD Risk 7.1%
• P=0.0003

16. Initial cohort referral
• 161 participants
– 78 referred (48.4%)
• 59 had BP > 140/90mmHg
• 7 had raised total cholesterol >7mmol/l
• 23 had BMI > 30
• 18 had Qrisk > 20

17. Follow up cohort
Wilcoxson’s Signed Rank Test
QRisk2 Mean 95% CI Median Difference
Two Sided
P
Approx
95% CI
All T1% 7.8 6.3-9.3 7 0.002 -1 to -0.5
All T2% 8.6 7.0-10.2 8
Fem T1% 5.6 4.2-7.0 4.5 0.1134 -1 to 0
Fem T2% 6.0 4.5-7.5 5
Male T1% 11.0 8.4-13.6 10 0.0095 -2 to -0.5
Male T2% 11.8 9.2-14.4 12
52 participants received repeat Health Check (at around 1 year)

18. DISCUSSION

19. Qrisk summary for all participants
Number
Qrisk %
0 10 20 30

20. Cardiovascular risk profile vs health Strategy
Ref: World Health Organisation. Prevention of Cardiovascular Disease. 2007

21. Conclusion
• Community pharmacy is able to identify and
refer high cardiovascular risk patients
• Community pharmacy can contribute to targets
for delivery of NHS Health Checks
• The extent to which community pharmacy can
contribute to longer term outcomes through NHS
Health Checks is unknown

22. Acknowledgement
• Grateful thanks to the Health Education
Foundation, whose educational bursary
supported this study

23. simon.j.butterworth@manchester.ac.uk
@SiButterworth