Journal article
Implementing decision aids for cardiovascular disease prevention: stakeholder interviews and case studies in Australian primary care
BMC Primary Care, Vol.25, pp.1-11
2024
PMCID: PMC10837956
PMID: 38310217
Abstract
Background:
Australian cardiovascular disease (CVD) prevention guidelines recommend absolute CVD risk assessment, but less than half of eligible patients have the required risk factors recorded due to fragmented implementation over the last decade. Co-designed decision aids for general practitioners (GPs) and consumers have been developed that improve knowledge barriers to guideline-recommended CVD risk assessment and management. This study used a stakeholder consultation process to identify and pilot test the feasibility of implementation strategies for these decision aids in Australian primary care.
Methods:
This mixed methods study included: (1) stakeholder consultation to map existing implementation strategies (2018-20); (2) interviews with 29 Primary Health Network (PHN) staff from all Australian states and territories to identify new implementation opportunities (2021); (3) pilot testing the feasibility of low, medium, and high resource implementation strategies (2019-21). Framework Analysis was used for qualitative data and Google analytics provided decision support usage data over time.
Results:
Informal stakeholder discussions indicated a need to partner with existing programs delivered by the Heart Foundation and PHNs. PHN interviews identified the importance of linking decision aids with GP education resources, quality improvement activities, and consumer-focused prevention programs. Participants highlighted the importance of integration with general practice processes, such as business models, workflows, medical records and clinical audit software. Specific implementation strategies were identified as feasible to pilot during COVID-19: (1) low resource: adding website links to local health area guidelines for clinicians and a Heart Foundation toolkit for primary care providers; (2) medium resource: presenting at GP education conferences and integrating the resources into audit and feedback reports; (3) high resource: auto-populate the risk assessment and decision aids from patient records via clinical audit software.
Conclusions:
This research identified a wide range of feasible strategies to implement decision aids for CVD risk assessment and management. The findings will inform the translation of new CVD guidelines in primary care. Future research will use economic evaluation to explore the added value of higher versus lower resource implementation strategies.
Details
- Title
- Implementing decision aids for cardiovascular disease prevention: stakeholder interviews and case studies in Australian primary care
- Authors
- Carissa Bonner (Corresponding Author) - The University of SydneySamuel Cornell - The University of SydneyKristen Pickles - The University of SydneyCarys Batcup - The University of SydneyCarl de Wet - Gold Coast HealthMark Morgan - Bond UniversityKim Greaves - University of the Sunshine Coast, Queensland, Faculty of Science, Health, Education and EngineeringDenise O'Connor - Monash UniversityAnna L. Hawkes - The University of QueenslandPaul Crosland - The University of SydneyNiamh Chapman - The University of SydneyJenny Doust - The University of Queensland
- Publication details
- BMC Primary Care, Vol.25, pp.1-11
- Publisher
- BioMed Central Ltd.
- Date published
- 2024
- DOI
- 10.1186/s12875-023-02258-4
- ISSN
- 2731-4553
- PMID
- 38310217; PMC10837956
- Copyright note
- © The Author(s) 2024. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
- Data Availability
- The data are not available as not permitted under ethics approval for qualitative transcripts or practice data.
- Grant note
- Funding for this research has been provided from the National Health and Medical Research Council (NHMRC) and the Australian Government’s Medical Research Future Fund (MRFF). The MRFF provides funding to support health and medical research and innovation, with the objective of improving the health and wellbeing of Australians. MRFF funding was provided to The Australian Prevention Partnership Centre under the MRFF Boosting Preventive Health Research Program.
- Organisation Unit
- Faculty of Science, Health, Education and Engineering
- Language
- English
- Record Identifier
- 991006997502621
- Output Type
- Journal article
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- Domestic collaboration
- Web Of Science research areas
- Primary Health Care
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