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

IF 1.6 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Australian Journal of General Practice Pub Date : 2024-09-01 DOI:10.31128/AJGP-06-23-6871
Carissa Bonner, James E Sharman, Shannon McKinn, Samuel Cornell, Mark R Nelson, Jenny Doust, Niamh Chapman
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Abstract

Background and objectives: Previous research identified numerous barriers to general practitioner (GP) use of cardiovascular disease (CVD) risk guidelines, and it is unclear whether these issues have been resolved. This study explored recent GP experiences.

Method: Interviews with 18 GPs in an Australian state with relatively few COVID-19 cases in 2021 were transcribed and coded using a framework analysis approach, with data mapped to five previously identified CVD risk assessment strategies: absolute risk focused, absolute risk adjusted, clinical judgement, passive disregard and active disregard.

Results: GPs used various CVD risk calculators to inform clinical decision making, but there were concerns about accuracy, the role of extra risk factors and less 'personalised' assessment. GPs addressed these concerns by requesting additional tests, subjectively adjusting the CVD risk assessment to account for extra risk factors and focusing on individual risk factors.

Discussion: Many barriers to CVD risk assessment guidelines remain. GP support is needed to implement revised guidelines.

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实施心血管疾病风险评估和管理指南所需的全科医生支持:定性访谈。
背景和目的:以往的研究发现,全科医生(GP)在使用心血管疾病(CVD)风险指南时面临诸多障碍,目前尚不清楚这些问题是否已经得到解决。本研究探讨了全科医生的最新经验:方法:采用框架分析方法,对澳大利亚一个2021年COVID-19病例相对较少的州的18名全科医生进行了访谈,并对访谈内容进行了转录和编码,同时将数据与之前确定的五种心血管疾病风险评估策略进行了映射,这五种策略分别是:注重绝对风险、绝对风险调整、临床判断、被动忽视和主动忽视:结果:全科医生使用各种心血管疾病风险计算器为临床决策提供信息,但对准确性、额外风险因素的作用以及 "个性化 "评估的不足表示担忧。全科医生通过要求额外的测试、主观调整心血管疾病风险评估以考虑额外的风险因素以及关注个人风险因素来解决这些问题:讨论:心血管疾病风险评估指南仍存在许多障碍。要实施修订后的指南,需要全科医生的支持。
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来源期刊
Australian Journal of General Practice
Australian Journal of General Practice Medicine-Family Practice
CiteScore
2.80
自引率
4.50%
发文量
284
期刊介绍: The Australian Journal of General Practice (AJGP) aims to provide relevant, evidence-based, clearly articulated information to Australian general practitioners (GPs) to assist them in providing the highest quality patient care, applicable to the varied geographic and social contexts in which GPs work and to all GP roles as clinician, researcher, educator, practice team member and opinion leader. All articles are subject to peer review before they are accepted for publication.
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