• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
Grand Rounds

Do General Adult Wellness Checks Improve Patient Health?

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE:

  • General health checks (ie., wellness visits, checkups, etc.) are commonly performed in adult primary care, though some trials have raised questions about their value and utility
  • Liss et al. (JAMA, 2021) reviewed the evidence on general health checks in multiple outcome domains that may be important to clinicians and patients

METHODS:

  • Systematic review
  • Inclusion criteria
    • RCTs and observational studies with control groups
  • Definition of health checks used in this this review: “Health care encounters that include multiple screenings, and identification of risk factors, with a goal of initiating early interventions to prevent future illness”

RESULTS:

  • 19 randomized trials (follow-up 1 to 30 years) | 13 observational studies (follow-up cross-sectional to 5 years)
  • General health checks were generally not associated with
    • Decreased mortality
    • Fewer cardiovascular events
    • Decreased cardiovascular disease incidence
  • In the South-East London Screening Study (n = 7229), adults aged 40 to 64 years who were invited to 2 health checks over 2 years experienced no 8-year mortality benefit over no screening
    • Screening: 6% mortality
    • No-screening: 5%
  • General health checks were associated with increased
    • Detection of chronic diseases (e.g. depression and hypertension)
    • Moderate improvements in controlling risk factors (e.g. blood pressure and cholesterol)
    • Increased clinical preventive service uptake (e.g. cancer screening)
    • Improvements in patient-reported outcomes (e.g. quality of life and self-rated health)
  • In the Danish Check-In Study (n = 1104), more patients randomized to receive to a single health check, compared to usual care, received a new antidepressant prescription over 1 year
    • With health check: 5% received new prescription
    • Usual care: 2%
    • P = 0.007
  • In a propensity score–matched analysis (n = 8917), a higher percentage of patients who attended a Medicare Annual Wellness Visit underwent colorectal cancer screening
    • Wellness visit: 69% underwent screening
    • No visit: 60%
    • P < 0.01
  • General health checks were associated with modest improvements in health behaviors such as physical activity and diet
  • In the OXCHECK trial (n = 4121), fewer patients who received annual health checks exercised less than once per month
    • Annual health checks: 68% exercised less than 1 time/month
    • No annual check: 71%
    • Difference 3.3% (95% CI, 0.5% to 6.1%)

CONCLUSION:

  • Significant limitations to this study include
    • Study is a review, not a meta-analysis (therefore no pooled effect sizes)
    • General health checks in these studies were generally infrequent with short follow-up durations
    • Uptake for health checks tend to be among advantaged groups who are relatively healthy at baseline or any disorders would have been diagnosed early
  • The authors state

Primary care teams may reasonably offer general health checks, especially for groups at high risk of overdue preventive services, uncontrolled risk factors, low self-rated health, or poor connection or inadequate access to primary care

Learn More – Primary Sources:

General Health Checks in Adult Primary Care: A Review

Want to stay on top of key guidelines and research papers?

ObGFirst® – Try It Free! »

image_pdfFavoriteLoadingFavorite
< Previous
All Grand Rounds Posts
Next >

Related ObG Topics:

Results of the DiRECT Trial: Can Weight Loss in a Primary Care Setting Achieve Remission of Type 2 Diabetes?
Results of the TASMINH4 Study: Does Self-Monitoring Blood Pressure Lead to Better Hypertension Outcomes?

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

Are you an
ObG Insider?

Get specially curated clinical summaries delivered to your inbox every week for free

  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Download Your ObG App
HERE!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Already a Member of ObGFirst®?

Please log in to ObGFirst to access the 2T US Atlas

Password Trouble?

Not an ObGFirst® Member Yet?

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!
ObGFirst Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site