Table 4.
GP knowledge, attitudes and beliefs in relation to absolute CVD risk (ACVDR) assessment: percentage agreeing with statements overall, and agreeing by ACVDR assessment rates (high vs moderate/low assessors), and associated crude and age-adjusted and sex-adjusted ORs
| Agree (%) |
High assessors (%) | Moderate/ low assessors (%) | Crude OR |
95% CI | Age-adjusted and sex-adjusted OR |
95% CI | P value | |
| GP factors | ||||||||
| I know how to use total CVD assessment tools | 90 | 96 | 88 | 3.1 | 0.61 to 15.68 | 2.31 | 0.40 to 13.50 | 0.35 |
| I know how to proceed after the total CVD risk assessment | 89 | 98 | 85 | 8.47 | 1.03 to 69.38 | 7.35 | 0.76 to 71.35 | 0.09 |
| The total CVD risk assessment allows for accurate calculation of CVD risk in elderly patients | 32 | 33 | 32 | 1.05 | 0.47 to 2.35 | 1.21 | 0.51 to 2.88 | 0.66 |
| The total CVD risk assessment estimates risk over too long a time period | 18 | 10 | 25 | 0.34 | 0.11 to 1.02 | 0.24 | 0.07 to 0.78 | 0.02 |
| I prefer to refer patients for a calcium score | 12 | 10 | 13 | 0.74 | 0.23 to 2.42 | 1.09 | 0.30 to 4.03 | 0.81 |
| I am comfortable with prescribing blood pressure and lipid lowering medications for patients identified at high total cardiovascular risk | 97 | 98 | 100 | Only 1 GP disagreed so no result | – | – | – | |
| I am comfortable with prescribing blood pressure and lipid lowering medications for patients identified at moderate total cardiovascular risk for whom despite lifestyle changes have not improved | 89 | 94 | 88 | 2.03 | 0.49 to 8.29 | 2.87 | 0.64 to 12.88 | 0.17 |
| I believe the total CVD risk assessment is a valuable tool for decision making | 86 | 95 | 93 | 1.56 | 0.27 to 8.90 | 1.48 | 0.21 to 10.62 | 0.70 |
| Patient factors | ||||||||
| Patient’s understand the concept of being at high risk of a chronic disease and are adherent to prescribed medications | 59 | 69 | 52 | 2.12 | 0.96 to 4.68 | 2.00 | 0.88 to 4.58 | 0.10 |
| Patients are willing to participate in lifestyle modification services | 52 | 63 | 45 | 2.10 | 0.97 to 4.55 | 2.29 | 1.02 to 5.15 | 0.05 |
| Organisational and structural factors | ||||||||
| I think there is sufficient time during a routine appointment to calculate total CVD risk | 77 | 90 | 70 | 3.77 | 1.28 to 11.08 | 3.79 | 1.23 to 11.61 | 0.02 |
| There are a lack of incentives for me to perform total CVD risk assessments | 39 | 41 | 38 | 1.11 | 0.51 to 2.40 | 1.15 | 0.51 to 2.61 | 0.74 |
| Total CVD risk assessments are difficult to incorporate opportunistically during patient consultations | 26 | 16 | 35 | 0.36 | 0.14 to 0.91 | 0.42 | 0.16 to 1.11 | 0.08 |
| Total cholesterol and HDL results are often not available for patients requiring total CVD risk assessment | 20 | 18 | 18 | 1.00 | 0.38 to 2.66 | 0.93 | 0.33 to 2.58 | 0.88 |
| There are a lack of effective lifestyle modification services to refer on to | 59 | 65 | 57 | 1.44 | 0.66 to 3.14 | 1.23 | 0.54 to 2.82 | 0.62 |
| There is lack of funding for lifestyle modification services to refer on to | 18 | 84 | 75 | 1.71 | 0.66 to 4.45 | 1.39 | 0.51 to 3.81 | 0.52 |
High assessors assessed cardiovascular disease (CVD) risk scores in ≥80% of their eligible patients. Moderate/low assessors assessed ACVDR in ≤79% of their eligible patients. Total questionnaires completed n=111. Data were incomplete in two (2%) patients, except for the question ‘I believe the total CVD risk assessment is a valuable tool for decision making’, which had nine (8%) missing. Percentage agreeing=proportion of GPS who ‘strongly agreed’, ‘agreed’ or ‘somewhat agreed’/total GPs who responded × 100.
GPs, general practitioners.