Effectiveness of general practice-based health checks: a systematic review and meta-analysis.
Br J Gen Pract
; 64(618): e47-53, 2014 Jan.
Article
en En
| MEDLINE
| ID: mdl-24567582
ABSTRACT
BACKGROUND:
A recent review concluded that general health checks fail to reduce mortality in adults.AIM:
This review focuses on general practice-based health checks and their effects on both surrogate and final outcomes. DESIGN ANDSETTING:
Systematic search of PubMed, Embase, and the Cochrane Central Register of Controlled Trials.METHOD:
Relevant data were extracted from randomised trials comparing the health outcomes of general practice-based health checks versus usual care in middle-aged populations.RESULTS:
Six trials were included. The end-point differences between the intervention and control arms in total cholesterol (TC), systolic and diastolic blood pressure (SBP, DBP), and body mass index (BMI) were -0.13 mmol/l (95% confidence interval [CI] = -0.19 to -0.07), -3.65 mmHg (95% CI = -6.50 to -0.81), -1.79 mmHg (95% CI = -2.93 to -0.64), and -0.45 kg/m(2) (95% CI = -0.66 to -0.24), respectively. The odds of a patient remaining at 'high risk' with elevated TC, SBP, DBP, BMI or continuing smoking were 0.63 (95% CI = 0.50 to 0.79), 0.59 (95% CI = 0.28 to 1.23), 0.63 (95% CI = 0.53 to 0.74), 0.89 (95% CI = 0.81 to 0.98), and 0.91 (95% CI = 0.82 to 1.02), respectively. There was little evidence of a difference in total mortality (OR 1.03, 95% CI = 0.90 to 1.18). Higher CVD mortality was observed in the intervention group (OR 1.30, 95% CI = 1.02 to 1.66).CONCLUSION:
General practice-based health checks are associated with statistically significant, albeit clinically small, improvements in surrogate outcome control, especially among high-risk patients. Most studies were not originally designed to assess mortality.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
/
2_ODS3
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6_ODS3_enfermedades_notrasmisibles
Problema de salud:
1_doencas_nao_transmissiveis
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2_muertes_prematuras_enfermedades_notrasmisibles
/
6_arterial_hypertension
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6_endocrine_disorders
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6_obesity
Asunto principal:
Medicina General
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Promoción de la Salud
Tipo de estudio:
Clinical_trials
/
Etiology_studies
/
Evaluation_studies
/
Risk_factors_studies
/
Systematic_reviews
Límite:
Adult
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Aged
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Humans
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Middle aged
Idioma:
En
Revista:
Br J Gen Pract
Año:
2014
Tipo del documento:
Article