GPPAQ not as fiddly as they would have you believe

Updated with correction 17th May

In this new QOF year there are two indicators added the the hypertension area about the assessment of physical activity. You can see the argument here - physical activity is generally good for the cardiovascular systems and specifically can have a beneficial effect on the blood pressure. There is a second indicator for a brief intervention to encourage exercise.

The chosen method to do this by the GPPAQ form with associated guidlines. The method of calculating this in the paper through that link is a bit fiddly. It involves cross referencing across two tables and is simply slow to do. There is an online version of the questionnaire at Patient.co.uk. Only the first three questions are used, the answers to rest are ignored, which seems a poor repayment of effort.


On closer inspection it appears that this is a needlessly complicated way of working out the result and that it is much easier to just allocate each answer a numerical value and calculate the result at the end. It should be no more complicated than working out the result of one of the "Smash Hits" personality analyses of my youth.

Is your occupation :

  • None or sedentary (0 points)
  • Standing (1 point)
  • Physical Handling (2 points)
  • Heavy lifting work (3 points)

How much physical exercise (jogging/gym/football/swimming but not cycling) do you do weekly?

  • None (0 points)
  • Less than an hour (1 point)
  • One to three hours (2 points)
  • More than three hours (3 points)

Home much cycling do you do a week?

  • None (0 points)
  • Less than an hour (1 point)
  • One to three hours (2 points)
  • More than three hours (3 points)

Just add up the points

  • Zero points - inactive
  • 0.5 to one point - moderately inactive
  • 1.5 to two points - moderately active
  • 2.5 points or more -active

Simple! Of course you may be thinking to yourself that you are sitting in front of a computing device of such power that it would have you burnt as a witch as late as the 1990s and you should not be asked to add up numbers yourself. In that case I have a javascript GPPAQ calculator which is no more or less accurate than the Patient.co.uk on but is less cluttered and I am happy for you to use the code in your own systems under BSD license.

If you use EMIS PCS I have written a protocol (with thanks to EMIS Support for squashing the bug) which asks you the questions and inserts the Read code automatically. You can download it here and then import it through protocol designer.


7 comments:

Anonymous said...

Hello when I calculate sedentary job, less than 1 hour cycling plus less than 1 hour physical activity it returns Moderately Active in the patient.co.uk version but Moderately Inactive in your version. I think there is an error in your scoring system as the Summary of the PAI would suggest it should be Moderately Active.

Gavin Jamie said...

Sorry. You are completely correct. Scoring updated on the web calculator and the table above.

Anonymous said...

Even simpler, just make it up; outcomes will be unaffected and we will have slightly more time to do something useful.

Paul Joshi said...

There is a inbuilt GPPAQ questionnaire in the new Hypertension template from EMIS (June 2013). Unlike this protocol which only read codes the final outcome the template read codes each of the components so its transparent how we arrived at the conclusion.

Anonymous said...

sorry to be dim, I don't seem to see how half points are arrived at. Can you please help

Anonymous said...

Gavin - I agree with previous comment - how are half points arrived at?

AngelaMetz said...

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