Improving the implementation of cardiovascular disease risk assessment in general practice

Key messages

• Despite the availability of guidelines for preventing cardiovascular disease (CVD), absolute risk (the risk of having a heart attack or stroke in the next five years) is often not assessed or used to guide management decisions.
• This implementation failure leads to unnecessary medication for some patients and preventable heart attacks and strokes for others. It has been estimated to cost $5.4 billion to the Australian health system.
• Previous trials to improve CVD risk assessment in primary care have not addressed discrepancies between assessment and management guidelines, or communication challenges between general practitioners (GPs) and patients.
• Since Primary Health Networks (PHNs) are well positioned to partner with key stakeholders to commission and coordinate new preventive services and programs we used their systems and programs to implement decision support tools to address GP and patient barriers.
• We demonstrated the feasibility of integrating decision aids that meet GP and patient needs with clinical education software and programs, leading to 70,000 uses of the tool.
• Our study identifies clear pathways for implementing the new CVD risk guidelines due in 2023. This requires coordination and planning with multiple stakeholders now, and adequate funding for implementation.
• If the guidelines are not implemented consistently, there is a risk they will increase inequity between population groups, including those at higher risk such as Aboriginal and Torres Strait Islander communities.