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General practitioner perceptions of assessment and reporting of absolute cardiovascular disease risk via pathology
Niamh Chapman1, Rebekah E McWhirter1,2, Martin G Schultz1
1Menzies Institute for Medical Research, College of Health and Medicine.
Insights
General practitioners (GPs) find that pathology services can improve cardiovascular disease (CVD) risk assessment by providing systematic reporting. This approach could enhance CVD prevention and patient care.
Area of Science:
- Cardiovascular disease prevention
- Health services research
- General practice
Background:
- Cardiovascular disease (CVD) prevention guidelines emphasize absolute CVD risk assessment.
- General practitioners (GPs) have limited utilization of these risk assessment tools in clinical practice.
Purpose of the Study:
- To explore GPs' perceptions of utilizing pathology services for assessing and reporting absolute CVD risk.
- To identify potential benefits and improvements for integrating CVD risk assessment into routine pathology reporting.
Main Methods:
- Qualitative study involving focus groups and semi-structured interviews with 18 GPs in Tasmania, Australia.
- Exploration of GPs' views on a proposed pathology service for absolute CVD risk assessment.
- Thematic coding of transcribed interviews by two independent researchers.
Main Results:
- GPs perceived that pathology-based CVD risk assessment could reduce appointment needs and provide a systematic approach.
- The service could mitigate misclassification of risk due to clinical intuition.
- All participating GPs indicated willingness to order absolute CVD risk assessment if offered via pathology services.
- GPs suggested including information on risk factor measurement methods in pathology reports.
Conclusions:
- Pathology services offering absolute CVD risk assessment can address practical challenges faced by GPs in CVD screening.
- This integrated approach may facilitate dedicated follow-up care for cardiovascular disease prevention.
Background:
Guidelines for cardiovascular disease (CVD) prevention recommend assessment of absolute CVD risk to guide clinical management. Despite this, use among general practitioners (GPs) remains limited.
Objective:
Pathology services may provide an appropriate setting to assess and report absolute CVD risk in patients attending for cholesterol measurement. This study aimed to explore GPs perceptions of such a service.
Methods:
A focus group and semi-structured interviews were conducted with GPs (n = 18) in Tasmania, Australia, to identify perceptions of assessment and reporting of absolute CVD risk via pathology services. An example pathology report including absolute CVD risk was provided and discussed. Audio-recordings were transcribed and thematically coded by two researchers.
Results:
Almost all GPs identified that absolute CVD risk assessed and reported via pathology services could address deficits in practice. First, by reducing the number of appointments required to collect risk factors. Second, by providing a systematic (rather than opportunistic) approach for assessment of absolute CVD risk. Third, by reducing misclassification of patient CVD risk caused by overreliance on clinical intuition. All GPs reported they would order absolute CVD risk when issuing a cholesterol referral if such a service was offered. GPs recommended improving the service by providing information on methods used to measure risk factors on the pathology report.
Conclusions:
Absolute CVD risk assessed and reported via pathology services may address challenges of screening CVD risk experienced by GPs in practice and encourage dedicated follow-up care for CVD prevention.
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