4.4 Article

Long-Term Effect of Population Screening for Diabetes on Cardiovascular Morbidity, Self-Rated Health, and Health Behavior

期刊

ANNALS OF FAMILY MEDICINE
卷 13, 期 2, 页码 149-157

出版社

ANNALS FAMILY MEDICINE
DOI: 10.1370/afm.1737

关键词

diabetes; screening; cardiovascular morbidity; self-rated; health; health behavior; ADDITION-Cambridge

资金

  1. Wellcome Trust [G061895]
  2. Medical Research Council [G0001164]
  3. National Health Service RD
  4. National Institute for Health Research (NIHR)
  5. MRC Epidemiology Unit
  6. University of Aarhus, Denmark
  7. ADDITION-Cambridge trial
  8. NIHR Research funds
  9. Department of Health NIHR Program Grant [RP-PG-0606-1259]
  10. NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London
  11. Medical Research Council [MC_U106179471, G0001164, MC_UU_12015/1, MC_UU_12015/4, MC_U106179474] Funding Source: researchfish
  12. National Institute for Health Research [RP-PG-0606-1259, NF-SI-0512-10135, 08/116/300] Funding Source: researchfish
  13. MRC [MC_U106179474, G0001164, MC_UU_12015/1, MC_UU_12015/4] Funding Source: UKRI

向作者/读者索取更多资源

PURPOSE There is limited trial evidence concerning the long-term effects of screening for type 2 diabetes on population morbidity. We examined the effect of a population-based diabetes screening program on cardiovascular morbidity, self-rated health, and health-related behaviors. METHODS We conducted a pragmatic, parallel-group, cluster-randomized controlled trial of diabetes screening (the ADDITION-Cambridge study) including 18,875 individuals aged 40 to 69 years at high risk of diabetes in 32 general practices in eastern England (27 practices randomly allocated to screening, 5 to no-screening for control). Of those eligible for screening, 466 (2.9%) were diagnosed with diabetes. Seven years after randomization, a random sample of patients was sent a postal questionnaire: 15% from the screening group (including diabetes screening visit attenders and non-attenders) and 40% from the noscreening control group. Self-reported cardiovascular morbidity, self-rated health (using the SF-8 Health Survey and EQ-5D instrument), and health behaviors were compared between trial groups using an intention-to-screen analysis. RESULTS Of the 3,286 questionnaires mailed out, 1,995 (61%) were returned, with 1,945 included in the analysis (screening: 1,373; control: 572). At 7 years, there were no significant differences between the screening and control groups in the proportion of participants reporting heart attack or stroke (OR = 0.90, 95% CI, 0.71-1.15); SF-8 physical health summary score as an indicator of selfrated health status (beta -0.33, 95% CI, -1.80 to 1.14); EQ-5D visual analogue score (beta: 0.80, 95% CI, -1.28 to 2.87); total physical activity (beta 0.50, 95% CI, -4.08 to 5.07); current smoking (OR 0.97, 95% CI, 0.72 to 1.32); and alcohol consumption (beta 0.14, 95% CI, -1.07 to 1.35). CONCLUSIONS Invitation to screening for type 2 diabetes appears to have limited impact on population levels of cardiovascular morbidity, self-rated health status, and health behavior after 7 years.

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