Riley, V, Ellis, NJ, Cowap, L, Grogan, S, Cottrell, E, Crone, D, Chambers, R, Clark-Carter, D, Fedorowicz, S and Gidlow, C (2020) A qualitative exploration of two risk calculators using video-recorded NHS health check consultations. BMC Family Practice, 21 (1). ISSN 1471-2296

[thumbnail of s12875-020-01315-6.pdf]
s12875-020-01315-6.pdf - Published Version
Available under License Creative Commons Attribution.

Download (1MB) | Preview


<jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>The aim of the study was to explore practitioner-patient interactions and patient responses when using QRISK®2 or JBS3 cardiovascular disease (CVD) risk calculators. Data were from video-recorded NHS Health Check (NHSHC) consultations captured as part of the UK RIsk COmmunication (RICO) study; a qualitative study of video-recorded NHSHC consultations from 12 general practices in the West Midlands, UK. Participants were those eligible for NHSHC based on national criteria (40–74 years old, no existing diagnoses for cardiovascular-related conditions, not on statins), and practitioners, who delivered the NHSHC.</jats:p> </jats:sec><jats:sec> <jats:title>Method</jats:title> <jats:p>NHSHCs were video-recorded. One hundred twenty-eight consultations were transcribed and analysed using deductive thematic analysis and coded using a template based around Protection Motivation Theory.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Key themes used to frame the analysis were Cognitive Appraisal (Threat Appraisal, and Coping Appraisal), and Coping Modes (Adaptive, and Maladaptive). Analysis showed little evidence of CVD risk communication, particularly in consultations using QRISK®2. Practitioners often missed opportunities to check patient understanding and encourage risk- reducing behaviour, regardless of the risk calculator used resulting in practitioner verbal dominance. JBS3 appeared to better promote opportunities to initiate risk-factor discussion, and Heart Age and visual representation of risk were more easily understood and impactful than 10-year percentage risk. However, a lack of effective CVD risk discussion in both risk calculator groups increased the likelihood of a maladaptive coping response.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>The analysis demonstrates the importance of effective, shared practitioner-patient discussion to enable adaptive coping responses to CVD risk information, and highlights a need for effective and evidence-based practitioner training.</jats:p> </jats:sec><jats:sec> <jats:title>Trial registration</jats:title> <jats:p>ISRCTN <jats:ext-link xmlns:xlink="" ext-link-type="uri" xlink:href="">ISRCTN10443908</jats:ext-link>. Registered 7th February 2017.</jats:p> </jats:sec>

Item Type: Article
Additional Information: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Uncontrolled Keywords: cardiovascular disease; risk communication; NHS health check; chronic disease prevention
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
Divisions: Faculty of Medicine and Health Sciences > School of Primary, Community and Social Care
Depositing User: Symplectic
Date Deposited: 08 Dec 2020 10:43
Last Modified: 08 Dec 2020 10:43

Actions (login required)

View Item
View Item