General practitioners' perspectives on the prevention of cardiovascular disease: systematic review and thematic synthesis of qualitative studies

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dc.contributor.authorJu, Irene
dc.contributor.authorBanks, Emily
dc.contributor.authorCalabria, Bianca
dc.contributor.authorJu, Angela
dc.contributor.authorAgostino, Jason
dc.contributor.authorKorda, Rosemary
dc.contributor.authorUsherwood, Tim
dc.contributor.authorManera, Karine
dc.contributor.authorHanson, Camilla S.
dc.contributor.authorCraig, Jonathan
dc.contributor.authorTong, Allison
dc.date.accessioned2019-06-25T04:24:25Z
dc.date.available2019-06-25T04:24:25Z
dc.date.issued2018
dc.date.updated2019-03-24T07:20:21Z
dc.description.abstractObjective Cardiovascular disease (CVD) is a leading cause of morbidity and mortality globally, and prevention of CVD is a public health priority. This paper aims to describe the perspectives of general practitioners (GPs) on the prevention of CVD across different contexts. Design Systematic review and thematic synthesis of qualitative studies using the Enhancing Transparency of Reporting the Synthesis of Qualitative research (ENTREQ) framework. Data sources MEDLINE, Embase, PsycINFO and CINAHL from database inception to April 2018. Eligibility criteria for selecting studies We included qualitative studies on the perspectives of GPs on CVD prevention. Data extraction and synthesis We used HyperRESEARCH to code the primary papers and identified themes. Results We selected 34 studies involving 1223 participants across nine countries. We identified six themes: defining own primary role (duty to prescribe medication, refraining from risking patients’ lives, mediating between patients and specialists, delegating responsibility to patients, providing holistic care); trusting external expertise (depending on credible evidence and opinion, entrusting care to other health professionals, integrating into patient context); motivating behavioural change for prevention (highlighting tangible improvements, negotiating patient acceptance, enabling autonomy and empowerment, harnessing the power of fear, disappointment with futility of advice); recognising and accepting patient capacities (ascertaining patient’s drive for lifestyle change, conceding to ingrained habits, prioritising urgent comorbidities, tailoring to patient environment and literacy); avoiding overmedicalisation (averting long-term dependence on medications, preventing a false sense of security, minimising stress of sickness) and minimising economic burdens (avoiding unjustified costs to patients, delivering practice within budget, alleviating healthcare expenses). Conclusions GPs sought to empower patients to prevent CVD, but consideration of patients’ individual factors was challenging. Community-based strategies for assessing CVD risk involving other health professionals, and decision aids that address the individuality of the patient’s health and environment, may support GPs in their decisions regarding CVD prevention. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial.en_AU
dc.description.sponsorshipThe work was supported by a National Health and Medical Research Council of Australia Partnership Grant (1092674), including support from the National Heart Foundation of Australia. AT is supported by a NHMRC Fellowship (1106716).en_AU
dc.format.mimetypeapplication/pdfen_AU
dc.identifier.issn2044-6055en_AU
dc.identifier.urihttp://hdl.handle.net/1885/164209
dc.language.isoen_AUen_AU
dc.provenance© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJen_AU
dc.publisherBMJ Publishing Groupen_AU
dc.relationhttp://purl.org/au-research/grants/nhmrc/1092674en_AU
dc.relationhttp://purl.org/au-research/grants/nhmrc/1106716en_AU
dc.rights© Author(s) (or their employer(s)) 2018.en_AU
dc.rights.licenseCreative Commons Attribution NonCommercial Licenseen_AU
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/en_AU
dc.sourceBMJ Openen_AU
dc.titleGeneral practitioners' perspectives on the prevention of cardiovascular disease: systematic review and thematic synthesis of qualitative studiesen_AU
dc.typeJournal articleen_AU
dcterms.accessRightsOpen Accessen_AU
local.bibliographicCitation.issue11en_AU
local.bibliographicCitation.startpagee021137en_AU
local.contributor.affiliationJu, Irene, The University of Sydneyen_AU
local.contributor.affiliationBanks, Emily, College of Health and Medicine, ANUen_AU
local.contributor.affiliationCalabria, Bianca, College of Health and Medicine, ANUen_AU
local.contributor.affiliationJu, Angela, The University of Sydneyen_AU
local.contributor.affiliationAgostino, Jason, College of Health and Medicine, ANUen_AU
local.contributor.affiliationKorda, Rosemary, College of Health and Medicine, ANUen_AU
local.contributor.affiliationUsherwood, Tim, Westmead Hospitalen_AU
local.contributor.affiliationManera, Karine, University of Sydneyen_AU
local.contributor.affiliationHanson, Camilla S. , Sydney School of Public Healthen_AU
local.contributor.affiliationCraig, Jonathan, The Children's Hospital at Westmeaden_AU
local.contributor.affiliationTong, Allison, The University of Sydneyen_AU
local.contributor.authoremailu4106314@anu.edu.auen_AU
local.contributor.authoruidBanks, Emily, u4106314en_AU
local.contributor.authoruidCalabria, Bianca, u3363025en_AU
local.contributor.authoruidAgostino, Jason, u5150077en_AU
local.contributor.authoruidKorda, Rosemary, u4013381en_AU
local.description.notesImported from ARIESen_AU
local.identifier.absfor110201 - Cardiology (incl. Cardiovascular Diseases)en_AU
local.identifier.absfor111706 - Epidemiologyen_AU
local.identifier.absseo920404 - Disease Distribution and Transmission (incl. Surveillance and Response)en_AU
local.identifier.ariespublicationu4485658xPUB2621en_AU
local.identifier.citationvolume8en_AU
local.identifier.doi10.1136/bmjopen-2017-021137en_AU
local.identifier.scopusID2-s2.0-85056042923
local.identifier.uidSubmittedByu4485658en_AU
local.publisher.urlhttps://authors.bmj.com/open-access/en_AU
local.type.statusPublished Versionen_AU

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