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Saturday 23 February 2019
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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.'
 
This story was first published on our sister publication Pulse.