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Table 1 Healthy Heart Study findings

From: 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

  Study description Implications
1 GP interviews about CVD risk assessment and management [16, 17] GPs use a range of CVD risk assessment strategies, and identified capability (knowledge, communication) opportunity (access, time) and motivation (habit, concerns about applicability of guidelines to certain patients) as key barriers to absolute risk assessment
2 Patient interviews about CVD risk assessment and management [18] Patient and GP decision making about CVD risk management is influenced by perceived risk and attitudes rather than calculated absolute risk of a CVD event
3 GP experiment to explore relative influence of absolute risk vs blood pressure/cholesterol on prescribing [19] Providing an absolute CVD risk assessment is not sufficient to overcome GPs’ tendency to prescribe medication based on blood pressure/cholesterol alone
4 Patient “think aloud” study using heart age calculators [20] Heart age calculators prompted emotional reactions and consideration of lifestyle changes, but unexpected ‘older’ heart age results were not believable
5 Patient experiment testing heart age versus 5-year absolute CVD risk [21] Heart age is easier to recall but also inflates risk perception and is less credible than 5-year absolute CVD risk, with no advantage for lifestyle change intentions
6 Patient “think aloud” study using absolute risk calculators [22] Absolute CVD risk is more meaningful when provided alongside a verbal description of the risk category and graphical displays of intervention effects for both lifestyle and medication
7 Systematic review of existing CVD risk calculators [23] There were 73 CVD risk calculators available online, but none matched Australian guidelines and they were not suitable for people with lower health literacy
8 Systematic review of CVD decision aids [24] There were 25 CVD decision aids available online, but none matched Australian guidelines, few presented both lifestyle and medication options in a balanced way, and they were not suitable for people with lower health literacy