Barriers to prevention: physician perceptions of ideal versus actual practices in reducing cardiovascular risk

We conducted a study to explore physician perceptions of factors that facilitate or inhibit the integration of preventive activities into primary care, particularly regarding the reduction of cardiovascular risk. Fifty randomly selected family physicians practising in the Maritimes were interviewed. Physicians described both ideal and actual practice in relation to reducing high blood pressure, reducing elevated serum cholesterol, and helping patients quit smoking. Perceived barriers related to 1) knowledge, attitudes, and perceptions (e.g., lack of counselling skills, lack of belief in the efficacy of the activities); 2) conditions in which the activities occur (e.g., lack of available and accessible referral, lack of time); and 3) reactions of others to the activities (e.g., lack of patient compliance).