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Health tests and health consultations reduced cardiovascular risk without psychological strain, increased healthcare utilization or increased costs

An overview of the results from a 5-year randomized trial in primary care. The Ebeltoft Health Promotion Project (EHPP)

Department of General Practice, Institute of Public Health, University of Aarhus, Denmark, tl{at}alm.au.dk

Morten Sig Ager Jensen

Department of General Practice, Institute of Public Health, University of Aarhus, Denmark

Janus Laust Thomsen

Department of General Practice, Institute of Public Health, University of Aarhus, Denmark

BO Christensen

Department of General Practice, Institute of Public Health, University of Aarhus, Denmark

Marianne Engberg

Department of General Practice, Institute of Public Health, University of Aarhus, Denmark

Background: Few randomized controlled trials (RCT) have evaluated health tests and health consultations in primary care with a long follow-up period. The Ebeltoft Health Promotion Project (EHPP) evaluated health tests and health consultations over a period of 5 years in the frame of a health technology assessment. Objective: To review the results of EHPP. Design: RCT with a control group answering questionnaires and two intervention groups having questionnaires, a comprehensive health test with written advice followed by either a normal consultation on demand or a planned 45 minutes patient-centred consultation. Setting: Primary care. Participants: The target population was all 30—49 year old persons in the municipality of Ebeltoft, Denmark. Invitations were received by 2000 randomly selected persons. Intervention: A comprehensive biomedical health test including a cardiovascular risk score (CVRS) followed by written advice and health consultations. Main outcome measures: Biomedical measures, psychological measures, healthcare contacts, life years gained, direct and total health costs. Results: At baseline 75% participated. During the 5 years 85% participated at least once. Elevated CVRS was found in 19% in the control group compared to 10% in the intervention groups (p<0.01) after 5 years. There were no measurable long term psychological reactions. Numbers of contacts to the healthcare system were not increased. Significantly better life expectancy was found without extra direct and total costs. Conclusions: An offer of health tests and patient-centred health consultations to the middle-aged population can be cost-effective and may be considered in the fight against the increasing burden of lifestyle diseases.

Key Words: Cardiovascular risk • general practice • health care costs • health care utilisation • health consultation • health test • middle-aged • multiphasic screening • prevention • psychological strain • randomized controlled trial

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