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Clinical Laboratories and Pathology Groups

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Clinical Laboratories and Pathology Groups

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UK’s NHS Offers Blood Pressure Screening for Men in Barber Shops and Other Public Locations in an Effort to Reach Consumers Where They Live and Work

This pioneering innovation is consistent with the trend to bring medical services to places more convenient for consumers and was spurred by a study which showed men twice as likely to have heart attacks than women

Patient-facing healthcare gets a boost with this novel program to offer a diagnostic service in locations frequented by men. In an attempt to decrease heart attacks in the UK, the country’s National Health Service (NHS) now employs a novel approach to prevention—bringing blood pressure screenings to the public in barbershops.

This is yet another example of moving diagnostics services out of traditional healthcare settings and reaching people in places that they visit in their daily lives. True, this is a blood pressure test. But once the service is established, it should be easy to collect other types of clinical laboratory specimens at barbershops as well. And if this approach enables healthcare policy makers to reach a population that needs further diagnostic tests—and it’s economically feasible—that may encourage adoption of this approach for other types of health screenings.

According to The Guardian, the screenings will be available at “barbershops, churches, mosques, community centers, and dominoes clubs.” The intention is to ensure screenings are more accessible, to educate the public, and to encourage lifestyle changes that lead to prevention.

This consumer-directed approach to healthcare by the NHS appears to be making a difference. The new screening locations already show promise. In 2023, efforts brought in 150,000 community-based blood pressure screenings by August. That more than doubled the previous year’s 58,000 that were performed by May, The Guardian noted.

The funding for this initiative is part of the NHS’ Delivery Plan for Recovering Access to Primary Care, an NHS England news release announced.

David Webb

“With the number of people living with major illnesses including heart disease and other cardiovascular conditions set to grow substantially over the coming years, it has never been more important to put in place preventive measures like easy-to-access blood pressure checks that can pick up the early signs and risks,” said David Webb (above), Chief Pharmaceutical Officer for England, NHS England, in a news release. Should this program succeed, it’s likely other types of clinical laboratory test specimens could also be collected in barbershops and other convenient locations. (Photo copyright: Paul Stuart/The Pharmaceutical Journal.)

Importance of Screening

According to the UK’s Health Foundation, more than 9.1 million people will have a major illness by 2040, and figures show an increase of 2.5 million from 2019 reports. These figures are “why prevention and early intervention tools such as community blood pressure checks are key priorities for the NHS,” the NHS news release states.

“Having high blood pressure raises the risk of a heart attack, but many men and women remain unaware they may be affected because typically there are no symptoms,” The Guardian reported. “Every year there are 100,000 NHS hospital admissions due to heart attacks—one every five minutes.”

The NHS’ moves were spurred by recent findings announced at the European Society of Cardiology’s 2023 annual meeting. The world’s largest heart conference showcased a 22-year-long study examining the gender-specific risks of cardiovascular diseases. The results clearly showed that men were twice as likely to experience heart attacks and peripheral artery disease than women.

The University of Aberdeen conducted the study which ran from 1993-2018 and followed 20,000 individuals over the age of 40. While researchers noted many factors—such as ethnicity, body mass index (BMI), physical activity, deprivation, consumption of alcohol, and cigarette smoke—a clear defining line landed between male and female participants, The Guardian reported. Additionally,“Men are also more likely to experience a heart attack at a younger age than women.”

And, according to the study, while cardiovascular disease was higher for men during their entire lifetime, “sex differences were most pronounced for myocardial infarction and peripheral artery disease, followed by atrial fibrillation, heart failure, and cardiovascular mortality,” The Guardian reported, adding, “Men also have a 50% higher risk of heart failure and atrial fibrillation. The study discovered that men have a 42% higher risk of dying from cardiovascular disease. The research did not look at why.”

Education Part of Prevention

“Men should start looking early at-risk factors, like obesity, lack of exercise, smoking, alcohol consumption, and reach out to their GP to get those things addressed. The earlier the better. There’s no harm in minimizing your cardiovascular risk,” Tiberiu Pana, MRes, lead researcher and honorary research fellow at the University of Aberdeen, told The Guardian. Pana is also a junior doctor in the NHS and focuses on cardiovascular epidemiology and the brain-heart interactions.

“Coronary heart disease is the most common killer of men. There’s never been a better time to get physically active and replace that pub session with an extra session in the gym,” cardiologist Sonya Babu-Narayan, MBBS, Associate Medical Director at the British Heart Foundation, told The Guardian. Babu-Narayan is also a consultant cardiologist at Royal Brompton Hospital.

Women, however, are not exempt from the risk of heart disease.

“If we consider the effects of heart disease over a lifetime, we need to remember that it costs lives for both men and women,” Babu-Narayan said. “With 30,000 women in the UK admitted to hospital with a heart attack each year, it is vital to dismantle the dogma that heart attacks are the preserve of men. Regardless of gender, cardiovascular disease is the world’s biggest killer and there are steps everyone can take to reduce their risks.”

In addition to the aforementioned community locations for screenings, NHS has launched a few other approaches to meet patients on their own turf.

A mobile blood pressure service named How’s Thi Ticker in Barnsley, South Yorkshire, “travels around local neighborhoods including to barber shops, supermarkets, and community centers, seeing more than a third of people referred to pharmacists with high blood pressure—freeing up GPs and catching early signs of heart attack and stroke risk,” according to the NHS news release.

Future Showing Further Promise

As the process continues, NHS expects to prevent 1,350 cardiovascular events every year, and expects to see 2.5 million more blood pressure checks performed in the community in England as a result of the endeavor, The Guardian noted.

One can only imagine how far this trend can go. Clinical laboratory managers and pathologists can expect healthcare policy makers in the UK to continue their efforts to bring needed diagnostic testing to underserved populations in accessible ways. This should be a win-win financially and in improving the health of the country’s population.

—Kristin Althea O’Connor

Related Information:

Men in England to Be Offered Blood Pressure Checks in Barbershops

NHS Blood Pressure Checks at the Barbers to Prevent Killer Conditions

Delivery Plan for Recovering Access to Primary Care

Swiss Researchers Developing a Smartphone-based Coagulation Test to Help Patients on Anticoagulation Therapy to Self-Test at Home

The device would save patients frequent trips to a hospital medical laboratory and automatically transmit coag test results to attending physicians

Researchers in Switzerland are putting coagulation testing together with a smartphone specifically to allow patients to do home self-testing. This is another example of how technology is getting closer to moving medical laboratory tests out of the core lab and into near-patient settings.

This groundbreaking work is being done by researchers at École Polytechnique Fédérale de Lausanne (EPFL) [Swiss Federal Institute of Technology]. They want to develop a smartphone device that enables patients to monitor their own anticoagulation therapy at home, according to a report published by Fiercemobilehealthcare.com. (more…)

Implantable Medical Laboratory-on-a-Chip Continuously Monitors Key Chemicals in Chemotherapy and High-Risk Patients

This innovative gadget can also telephone the doctor to warn of an eminent event, like heart attack, before it occurs

French researchers are zeroing in on a tiny, chip-based medical laboratory test device designed to be implanted under the skin. This miniature blood laboratory may revolutionize healthcare by continuously monitoring high-risk, chronically ill patients.

This ground-breaking work is being done by developers at the École Polytechnique Fédérale de Lausanne (EPFL), or Swiss Institute of Technology, in Lausanne, Switzerland. The implantable lab-testing device is linked to the user’s cell phone and can send alerts to doctors before symptoms are evident. (more…)

Anticipating the Digital Medicine Revolution, Scripps Doctor Prescribes Smartphone Apps as Frequently as Medications

Pathologists will want to engage with physicians as wireless devices and smartphone apps make it possible to maintain continuous surveillance of the body

Pathologists might want to borrow a page from a tech-savvy doctor who was voted the “Most Influential Physician Executive” in 2012. A cardiologist, this physician says he now prescribes mobile applications for his patients almost as frequently as he prescribes therapeutic drugs.

Many clinical laboratory managers will recognize the name of Eric Topol, M.D., who is the Director of the Scripps Translational Science Institute, Professor of Genomics at the Scripps Research Institute, and Chief Academic Officer at Scripps Health, all located in La Jolla, California. Topol has a passion for wireless medical technology. Moreover, he is nationally recognized as a wireless medical technology trailblazer, as well as for his medical expertise.

In fact, in one news clip, NBC News touts him as the nation’s foremost expert in the explosion of wireless medicine. Topol was also selected by GQ Magazine in 2009 as one of the nation’s 12 “Rock Stars of Science.” (more…)

UK Junior Doctors Ordering Lab Tests They Can’t Interpret

Findings of a recent study on laboratory test ordering confirm what is widely-known by laboratory professionals across the globe. In the United Kingdom, many junior doctors do not understand common hospital laboratory tests and are putting patients at risk as a result. This was the primary observation of UK biochemists in a recently-published study.

Dr. Trevor Grey from the Northern General Hospital in Sheffield, England surveyed 80 junior doctors, asking them how they felt about the clinical biochemistry tests they were expected to order on a daily basis. His findings were published as “Learning Needs in Clinical Biochemistry for Doctors in Foundation Years” in the January 2008 issue of The Annals of Clinical Biochemistry. The article reported that one in five (18%) of more than 80 junior doctors surveyed were happy to order a test they could not fully interpret. The article, along with an editorial piece by Dr. Danielle Freedman of the Association of Clinical Biochemistry, blamed both poor teaching and a reduction the amount of pathology and laboratory medicine taught at medical schools.

When asked about 12 common lab tests, junior doctors questioned during this survey said they were not entirely confident about interpreting the results for 10 of them. For three common types of lab tests, more than one-third of the junior doctors surveyed said they were not confident about interpreting the results. 18% of the junior doctors said they were happy to order a test which they did not fully understand how to interpret. Seven out of 10 junior doctors said they would find more teaching in biochemistry to be useful.

In Freedman’s editorial, she said the results revealed “a national problem” in the UK. She knew of situations where patients were discharged from a hospital, only to suffer a major heart attack because a key laboratory test had either not been ordered or the results had not triggered an appropriate clinical response. The UK’s General Medical Council is currently preparing to review its guidance on the content of medical education.

Across the laboratory medicine profession, there is recognition that time devoted to pathology and clinical lab testing in medical school is often not adequate to teach new physicians to be: 1) both competent and confident in ordering the right tests at the appropriate time; then 2) responding to the lab test results with the correct, recommended actions. Efforts to constantly improve patient safety will eventually evaluate and assess how young physicians are using laboratory tests. It will take a few more years for that to happen.

However, when real-time data is gathered that links errors in patient care to inappropriate ordering of lab tests and improper response to test results by young physicians-who were not properly trained during their medical education-only then is it likely that healthcare systems in the UK and other countries will take active steps to remedy this long-recognized deficiency.

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