Sustaining cardiovascular absolute risk management in Australian general practice

Area of Science:

• General Practice
• Preventive Cardiology
• Health Behavior Change

Background:

• Cardiovascular disease prevention relies on accurate risk assessment.
• Integrating absolute cardiovascular risk (CVAR) assessment into general practice is crucial for patient management.
• Understanding long-term GP and patient perspectives on CVAR assessment is essential for sustained implementation.

Purpose of the Study:

• To explore GP and patient attitudes and practices 12 months after a trial of absolute cardiovascular risk assessment.
• To identify factors influencing the sustained use of CVAR assessment in general practice.
• To understand patient adherence and relapse in behavior change following CVAR assessment.

Main Methods:

• Qualitative study using semistructured interviews.
• 12 general practitioners (GPs) from the intervention arm of a cluster randomised controlled trial.
• 15 moderate to high-risk patients who participated in CVAR assessments.

Main Results:

• Most GPs sustained CVAR assessment, primarily for patient motivation and adherence, not solely for pharmacotherapy decisions.
• Time constraints were a significant barrier for GPs utilizing CVAR assessment.
• Patients sustaining behavior change internalized health benefits and had social support; relapses were linked to motivation and external factors.

Conclusions:

• Sustained CVAR assessment in general practice requires integration into practice information systems and planned preventive care.
• Long-term impact on patient behavior necessitates ongoing support and system integration.
• Addressing GP time barriers and patient motivational factors is key for effective CVAR implementation.