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Barriers to Implementing Cardiovascular Risk Calculation in Primary Care: Alignment With the Consolidated Framework
Leah Tuzzio1, Ellen S O'Meara1, Erika Holden1
1Kaiser Permanente Washington Health Research Institute, Seattle, Washington.
American Journal of Preventive Medicine
|December 6, 2020
Summary
Primary care clinics face barriers to using cardiovascular disease risk calculators, including time constraints and limited access. Addressing these implementation challenges is key to improving adoption and preventive care strategies.
Area of Science:
- Implementation Science
- Primary Care Medicine
- Cardiovascular Disease Prevention
Background:
- Cardiovascular disease (CVD) risk calculators aid preventive strategies but show slow uptake in primary care.
- Identifying barriers to calculator implementation is crucial for promoting adoption.
Purpose of the Study:
- To qualitatively analyze physician educator notes to identify barriers to CVD risk calculator implementation in primary care settings.
Main Methods:
- Physician educator notes from 44 primary care clinics in the EvidenceNOW Healthy Hearts Northwest trial were qualitatively analyzed.
- Barriers were coded and aligned with the Consolidated Framework for Implementation Research.
Main Results:
- Thirteen barriers to CVD risk calculator implementation were identified.
- The most common barriers included time constraints (23 clinics), access limitations (22 clinics), lack of clinician buy-in (19 clinics), patient concerns about statins (17 clinics), and workflow issues (16 clinics).
- Most barriers (62%) mapped to the 'Inner Setting' domain of the implementation framework.
Conclusions:
- Future research should tailor interventions to address common barriers for improving CVD risk calculator uptake.
- Addressing time, access, buy-in, patient factors, and workflow is essential for successful implementation in primary care.
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