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PHE heart age campaign regional pilot sent hundreds of patients to their GP

A pilot of Public Health England’s controversial 'heart age' test covering one part of England, sent nearly 800 patients to their GP over two months, according to the campaign evaluation.

The trial, which took place in February and March in parts of the South West of England, involved pharmacies encouraging people to take an online test to find out their ‘heart age’ and risk of suffering a heart attack or stroke.

This pilot came before the launch of the national campaign – which was widely criticised by GPs for encouraging an influx of worried-well patients to practices.

Nearly 600 pharmacies in the NHS England South South-West region took part in the pilot, with 8822 conversations regarding the heart age tool recorded, according to the PHE evaluation.

This led to ‘771 patients being referred to their GP', it said.

The report also noted that many older populations were reported as not able to access the tool, due to not having access to the internet or not being confident using their devices.

This local pilot was followed by the national heart age campaign in September last year, which asked members of the public over 30 to take the online test to find out their 'heart age'.

GPs quickly expressed concern, pointing out that it did not align with current NHS advice on health screenings. 

The tool was particularly surprising, considering NICE previously rejected the use of lifetime risk scores - such as the one this test is based on - due to a lack of evidence.

The test, which is still available online and involves a number of physical and lifestyle questions, provides an immediate estimation of the person's heart age, as well as a prediction of their risk of having a heart attack or stroke by a certain age.

However, if the person does not know their blood pressure or cholesterol level when completing the quiz, it tells them they need to get tested and should make an appointment with their GP, nurse or pharmacist.

This immediately raised alarm bells for GPs and clinicians who worried that general practice was going to see an influx of patients without risk factors.

No figures on the impact of the national campaign have yet been released.

Commenting on the regional evaluation however, GP and clinical research fellow at the University of Birmingham Dr Samuel Finnikin said it does not show whether this campaign is actually 'useful', and questioned the lack of data on cost-effectiveness.

He said: 'It’s difficult to draw many conclusions from this evaluation. The referral rate itself doesn’t help us establish whether this was a useful exercise. There a some people who don’t go to their GP, have raised CVD risk and have never had discussions about reducing risk of CVD. If this service highlights these people and gives them to opportunity to discuss primary prevention then that’s great.

'However, if people who are low risk are being referred, there may not be much value in seeing the GP and therefore it isn’t a great use of resource. It was good to see in the comments that many pharmacists were taking on the challenge of giving good quality lifestyle advice and encouraging smoking cessation. This is where real health improvements could be made.

'But I wonder how much money has been put into this? A proper evaluation should include a cost benefit analysis with some robust outcome data – perhaps this is to come at a later stage?'

PHE national lead for cardiovascular disease Professor Jamie Waterall said: 'The heart age test is a simple way of helping people think about their heart health and it has strong clinical and academic support.

'Pharmacies supporting the campaign offer blood pressure checks and, in some cases, people may need to be referred to their GP if they are found to have high blood pressure. But in most cases, pharmacies will offer lifestyle advice to help people manage their risk.'

Last year, Pulse revealed the pharmaceutical funding behind many disease awareness campaigns driving worried-well patients to their GP, including the links between the Heart Age Campaign and drug-companies.

Readers' comments (4)

  • WE HAVE A "BLOCK CONTRACT"...WHO ELSE IN SOCIETY WOULD HAVE SUCH A CRAZY CONTRACT?
    PLUMBERS?
    BANKERS?
    TAXI-DRIVERS?
    WE SIMPLY NEED AN "ACTIVITY-BASED" CONTRACT LIKE SECONDARY CARE BUT GIVEN OUR LEADERS WOULD SELL THEIR OWN GRANNY TO APPEASE THE GOVERNMENT, WE ARE DOOMED.

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  • PHE ignoring NICE? Makes you wonder about their objectivity eh. Lets see PHE funding or transparency into their decision-making process. Maybe some proper journalist can ask Professor Jamie Waterall some difficult qsns...

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  • Hi Christopher, you might want to look at this: http://www.pulsetoday.co.uk/home/finance-and-practice-life-news/revealed-the-awareness-campaigns-that-risk-distorting-clinical-priorities/20037552.article

  • Cheers, Editor. I did read that one but I'm curious about any direct 'influence' of Pharma on PHE itself... Only transparency and investigative journalism can shed light on that.

    And the comments in the other article: "The NSC – through the PHE press office – declined to comment. But, for its part, PHE says: ‘The Heart Age Test is a simple way to help people think about heart health and has strong clinical and academic support. It has been available for over three years and there is no evidence that it results in people attending their GP practice unnecessarily.

    ’PHE’s work to protect and improve the nation’s health and wellbeing is entirely independent and underpinned by world-leading science, knowledge and intelligence.’

    is entirely contradictory to this article

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  • Dear Professor Waterfall,
    You say ;

    "The heart age test is a simple way of helping people think about their heart health and it has strong clinical and academic support."

    What you forget to mention is that it has not a shred of research evidence based support.
    If I remember correctly the GMC expects doctors to act honestly and with integrity.
    Regards
    Paul C



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