Coronary heart disease multiple risk factor reduction. Providers' perspectives
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Authors
Rosal, Milagros C.Ockene, Judith K.
Luckmann, Roger S.
Zapka, Jane G.
Goins, Karin V.
Saperia, Gordon M.
Mason, Theresa
Donnelly, Gary
UMass Chan Affiliations
Department of Family Medicine and Community HealthDepartment of Medicine, Division of Preventive and Behavioral Medicine
Document Type
Journal ArticlePublication Date
2004-08-01Keywords
AdultCoronary Disease
Diabetes Complications
Female
Focus Groups
*Health Behavior
Humans
Hypertension
Male
Middle Aged
*Physician-Patient Relations
Preventive Health Services
*Primary Health Care
Risk Factors
Smoking
Life Sciences
Medicine and Health Sciences
Women's Studies
Metadata
Show full item recordAbstract
BACKGROUND: Although primary care physicians understand the importance of preventive services for patients with multiple risk factors (MRF) for coronary heart disease, physician intervention is limited. This study investigated (1) physicians' views of challenges faced in managing patients with MRF; (2) the counseling and management methods they utilize; and (3) possible strategies to enhance MRF intervention in the primary care setting. METHODS: Two focus groups were conducted with primary care physicians from varying settings to gain insight into these issues noted above. Each group was co-facilitated by a physician and a behavioral scientist using a previously developed semistructured interview guide. The group discussions were tape recorded and subsequently transcribed. Transcripts were analyzed using the constant comparative method for analysis. RESULTS: Physicians are challenged by knowledge limitations (contribution of individual risk factors to overall risk); limited support (guidelines, materials, and staff); and logistic difficulties (organizational issues, time limitations). Their approach to MRF management tends to be highly individualized with an initial preference for lifestyle change interventions rather than prescription of medications with some qualifying circumstances. Physicians favored a serial rather than a parallel approach to MRF intervention, starting with behaviors that the patient perceives as a priority. Proposed solutions to current challenges emphasize physician education and the development of innovative approaches that include physician assistance and a team approach. CONCLUSIONS: Physicians are aware of and sensitive to the complexity of MRF management for their patients and themselves. However, future MRF interventions will require nonphysician staff involvement and increased systems support.Source
Am J Prev Med. 2004 Aug;27(2 Suppl):54-60. Link to article on publisher's siteDOI
10.1016/j.amepre.2004.04.020Permanent Link to this Item
http://hdl.handle.net/20.500.14038/50891PubMed ID
15275674Related Resources
Link to article in PubMedae974a485f413a2113503eed53cd6c53
10.1016/j.amepre.2004.04.020