General practitioners' use of different cardiovascular risk assessment strategies: a qualitative study

Bonner, C; Jansen, J; McKinn, S; Irwig, L; Doust, J; Glasziou, P; Hayen, A; McCaffery, K

General practitioners' use of different cardiovascular risk assessment strategies: a qualitative study

Bonner, C Jansen, J McKinn, S Irwig, L Doust, J Glasziou, P Hayen, A

McCaffery, K

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Publication Type:: Journal Article
Citation:: The Medical journal of Australia, 2013, 199 (7), pp. 485 - 489
Issue Date:: 2013-10-07

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Field	Value	Language
dc.contributor.author	Bonner, C	en_US
dc.contributor.author	Jansen, J	en_US
dc.contributor.author	McKinn, S	en_US
dc.contributor.author	Irwig, L	en_US
dc.contributor.author	Doust, J	en_US
dc.contributor.author	Glasziou, P	en_US
dc.contributor.author	Hayen, A https://orcid.org/0000-0003-4046-8030	en_US
dc.contributor.author	McCaffery, K	en_US
dc.date.available	2013-08-05	en_US
dc.date.issued	2013-10-07	en_US
dc.identifier.citation	The Medical journal of Australia, 2013, 199 (7), pp. 485 - 489	en_US
dc.identifier.uri	http://hdl.handle.net/10453/116990
dc.description.abstract	OBJECTIVES: To identify factors that influence the extent to which general practitioners use absolute risk (AR) assessment in cardiovascular disease (CVD) risk assessment.DESIGN, SETTING AND PARTICIPANTS: Semi-structured interviews with 25 currently practising GPs from eight Divisions of General Practice in New South Wales, Australia, between October 2011 and May 2012. Data were analysed using framework analysis.RESULTS: The study identified five strategies that GPs use with patients in different situations, defined in terms of the extent to which AR was used and the reasons given for this: the AR-focused strategy, used when AR assessment was considered useful for the patient; the AR-adjusted strategy, used to account for additional risk factors such as family history; the clinical judgement strategy, used when GPs considered that their judgement took multiple risk factors into account as effectively as AR; the passive disregard strategy, used when GPs lacked sufficient time, access or experience to use AR; and the active disregard strategy, used when AR was considered to be inappropriate for the patient. The strategies were linked with different opportunity, capability and motivation barriers to the use of AR.CONCLUSIONS: This study provides an in-depth insight into the factors that influence GPs' use of AR in CVD risk assessment. The results suggest that GPs use a range of strategies in different situations, so different approaches may be required to improve the use of AR guidelines in practice.	en_US
dc.relation.ispartof	The Medical journal of Australia	en_US
dc.subject.classification	General & Internal Medicine	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Cardiovascular Diseases	en_US
dc.subject.mesh	Risk Assessment	en_US
dc.subject.mesh	Risk Factors	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	General Practitioners	en_US
dc.subject.mesh	Interviews as Topic	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	New South Wales	en_US
dc.subject.mesh	Practice Patterns, Physicians'	en_US
dc.title	General practitioners' use of different cardiovascular risk assessment strategies: a qualitative study	en_US
dc.type	Journal Article
utslib.citation.volume	7	en_US
utslib.citation.volume	199	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	11 Medical and Health Sciences	en_US
utslib.for	17 Psychology and Cognitive Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	closed_access
pubs.issue	7	en_US
pubs.publication-status	Published	en_US
pubs.volume	199	en_US

Abstract:

OBJECTIVES: To identify factors that influence the extent to which general practitioners use absolute risk (AR) assessment in cardiovascular disease (CVD) risk assessment.DESIGN, SETTING AND PARTICIPANTS: Semi-structured interviews with 25 currently practising GPs from eight Divisions of General Practice in New South Wales, Australia, between October 2011 and May 2012. Data were analysed using framework analysis.RESULTS: The study identified five strategies that GPs use with patients in different situations, defined in terms of the extent to which AR was used and the reasons given for this: the AR-focused strategy, used when AR assessment was considered useful for the patient; the AR-adjusted strategy, used to account for additional risk factors such as family history; the clinical judgement strategy, used when GPs considered that their judgement took multiple risk factors into account as effectively as AR; the passive disregard strategy, used when GPs lacked sufficient time, access or experience to use AR; and the active disregard strategy, used when AR was considered to be inappropriate for the patient. The strategies were linked with different opportunity, capability and motivation barriers to the use of AR.CONCLUSIONS: This study provides an in-depth insight into the factors that influence GPs' use of AR in CVD risk assessment. The results suggest that GPs use a range of strategies in different situations, so different approaches may be required to improve the use of AR guidelines in practice.

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http://hdl.handle.net/10453/116990