NHS health checks and QOF increase overtreatment

摘要

GPs in the UK have two options when dealing with the massive numbers of patients who present because of mildly raised blood pressure readings.Option 1: we can diligently checkthe blood pressure many times, discuss lifestyle changes, and arrange regular follow-up, when we will have to go through the whole discussion about treatingornottreatingwith drugs again. When such a patient has a stroke we will be blamed.Option 2: we can start the patient on drugs and treatthe blood pressure accordingto a protocol, probably delegating the job to a nurse. If the patient has a stroke, we are not blamed. If the patient gets side effects that is the drug's fault, not ours. We will be paid more because our "prevalence" of hypertension will be high and itwill be easy to hit our Quality and Outcomes Framework (QOF) targets for blood pressure control.