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Implementing decision aids for cardiovascular disease prevention: stakeholder interviews and case studies in Australian primary care

Resource type
Authors/contributors
Title
Implementing decision aids for cardiovascular disease prevention: stakeholder interviews and case studies in Australian primary care
Abstract
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.
Publication
BMC Primary Care
Date
2024-02-03
Volume
25
Issue
1
Pages
49
Journal Abbr
BMC Prim. Care
Accessed
7/7/25, 1:23 AM
ISSN
2731-4553
Short Title
Implementing decision aids for cardiovascular disease prevention
Language
en
Library Catalog
DOI.org (Crossref)
Notes

Study topic:
Feasibility and implementation of co-designed decision aids for cardiovascular disease (CVD) risk assessment and management in Australian primary care.

Study type:
Mixed methods study including stakeholder consultation, interviews with Primary Health Network staff, and pilot testing of implementation strategies.

Key value statements:

  • Decision aids for CVD prevention were integrated into GP workflows via HealthPathways, clinical audit software, and education programs.
  • Low, medium, and high resource strategies were tested, including website links, CPD workshops, audit reports, and auto-populated decision support tools.
  • HealthPathways was used to host and promote decision aids, contributing to increased website traffic and tool uptake.
  • Integration with practice software and alignment with business models were critical for feasibility.
  • Findings support a coordinated national approach to implementing CVD guidelines using decision support tools.
Citation
Bonner, C., Cornell, S., Pickles, K., Batcup, C., De Wet, C., Morgan, M., Greaves, K., O’Connor, D., Hawkes, A. L., Crosland, P., Chapman, N., & Doust, J. (2024). Implementing decision aids for cardiovascular disease prevention: stakeholder interviews and case studies in Australian primary care. BMC Primary Care, 25(1), 49. https://doi.org/10.1186/s12875-023-02258-4