Carissa Bonner|Michael Anthony Fajardo|Jenny Doust|Kirsten McCaffery|Lyndal Trevena
Implementing cardiovascular disease prevention guidelines to translate evidence-based medicine and shared decision making into general practice: theory-based intervention development, qualitative piloting and quantitative feasibility
University of Sydney|University of Sydney|Bond University|University of Sydney|University of Sydney
use cardiovascular disease cvd prevention guidelines based absolute risk assessment poor around world including australia behavioural barriers amongst gps patients include capability eg difficulty communicatingunderstanding risk motivation eg attitudes towards guidelinesmedication paper outlines theorybased development website gp guidelines piloting new risk calculatordecision aid stage 1 involved identifying evidencebased solutions using behaviour change wheel bcw framework informed previous research involving 400 gps 600 patientsconsumers stage 2 codeveloped website content gps stage 3 piloted prototype website national gp conference stage 4 iteratively improved website based think aloud interviews gps patients stage 5 feasibility study evaluate potential efficacy guidelinesbased recommendations risk category acceptability intended use demand actual use 1 month amongst gps n 98 stage 1 identified gps target behaviour change need new risk calculatordecision aid linked existing audit feedback training online guidelines delivery format stage 24 iteratively improved content format based qualitative feedback gp patient user testing three rounds website development stage 5 suggested potential efficacy improved identification hypothetical high risk patients 26 76 recommended medication 57 86 viewing website n 42 prescribing low risk patients remained similar 19 22 n 37 gps 89 indicated would use website next month 72 reported using one month n 98 open feedback identified implementation barriers including need integration medical software low health literacy resources preconsultation assessment following theorybased development process user codesign resulting intervention acceptable gps high intentions use improved identification patient risk categories guidelinesbased prescribing intentions high risk low risk patients effectiveness linking intervention clinical practice closely address implementation barriers evaluated future research