General practitioner support needs to implement cardiovascular disease risk assessment and management guidelines:...

Area of Science:

• Cardiology
• General Practice
• Health Services Research

Background:

• Previous studies identified barriers to general practitioner (GP) adoption of cardiovascular disease (CVD) risk guidelines.
• It remains unclear if these previously identified barriers persist.
• This study investigates recent GP experiences with CVD risk assessment.

Purpose of the Study:

• To explore current barriers and adaptations in GP use of CVD risk assessment guidelines.
• To understand how GPs navigate challenges in applying CVD risk guidelines in clinical practice.

Main Methods:

• Qualitative study involving interviews with 18 GPs in an Australian state in 2021.
• Framework analysis of transcribed interviews.
• Data mapped to five CVD risk assessment strategies: absolute risk focused, absolute risk adjusted, clinical judgement, passive disregard, and active disregard.

Main Results:

• GPs utilized various CVD risk calculators but expressed concerns regarding accuracy, inclusion of additional risk factors, and personalized assessment.
• GPs addressed these concerns by ordering extra tests, subjectively modifying risk assessments for additional factors, and focusing on individual risk profiles.
• Adaptations indicate ongoing challenges in guideline implementation.

Conclusions:

• Significant barriers to implementing CVD risk assessment guidelines persist for GPs.
• Enhanced GP support is crucial for the successful implementation of revised CVD risk guidelines.