SHINE Patient and Public Involvement

How patients were involved in designing this research?

Patient representatives informed the design of this study. This included patient representatives from a Patient Participation Group of an Oxfordshire GP surgery, British Heart Foundation’s Heart Voices group, and the National Association for Patient Participation. There were several common themes among discussions with patient representatives from these groups:

• Patients expect their health service to screen for undiagnosed diseases, such as hypertension using routinely collected data.
• Patients would like to be informed of diseases early, before they develop symptoms and before opportunities to prevent serious illness are missed.
• Patients would like screening for undiagnosed diseases to be inclusive, but as tailored and targeted as possible to ensure screening interventions are delivered to those most likely to benefit.

This helped us understand that:

• Patients in hospital would be likely to feel positive about their routinely collected healthcare data being screened by a research team for the SHINE study.
• Patients in hospital would feel comfortable to undergo non-invasive tests to investigate whether they have undiagnosed hypertension
• We should use the data from the SHINE study to investigate whether individual characteristics (such as age, sex and body mass index as well as blood pressure) are associated with a diagnosis of hypertension, so that we can predict more accurately who is at risk of having undiagnosed hypertension
• We should use this information to design a calculation that informs patients of their percentage likelihood of having undiagnosed hypertension.

We sought further opinions from the public by surveying shoppers in the Westgate Centre in Oxford City Centre during the BRC Open Day in May 2023. We asked 25 adults the following question:

How high would your chance of having high blood pressure need to be, for you to want to have your blood pressure checked?

On average, people told us they would like to be given a blood pressure check if their risk of having undiagnosed hypertension exceeds 45%. We are now doing further work to understand the cost and health consequences to the NHS and patients, if a community blood pressure check was offered to all hospital inpatients predicted to have a risk of undiagnosed hypertension of 45% or more.