چکیده (انگلیسی):

Background:Cardiovascular disease (CVD) prevention guidelines encourage assessment of absolute CVD risk - the
probability of a CVD event within a fixed time period, based on the most predictive risk factors. However, few
General Practitioners (GPs) use absolute CVD risk consistently, and communication difficulties have been identified
as a barrier to changing practice. This study aimed to explore GPs’ descriptions of their CVD risk communication
strategies, including the role of absolute risk.
Methods:Semi-structured interviews were conducted with a purposive sample of 25 GPs in New South Wales,
Australia. Transcribed audio-recordings were thematically coded, using the Framework Analysis method to ensure
rigour.
Results:GPs used absolute CVD risk within three different communication strategies:‘positive’, ‘scare tactic’, and
‘indirect’.A‘positive’ strategy, which aimed to reassure and motivate, was used for patients with low risk,
determination to change lifestyle, and some concern about CVD risk. Absolute risk was used to show how they
could reduce risk. A‘scare tactic’ strategy was used for patients with high risk, lack of motivation, and a dismissive
attitude. Absolute risk was used to‘scare’ them into taking action. An ‘indirect’ strategy, where CVD risk was not the
main focus, was used for patients with low risk but some lifestyle risk factors, high anxiety, high resistance to
change, or difficulty understanding probabilities. Non-quantitative absolute risk formats were found to be helpful in
these situations.
Conclusions:This study demonstrated how GPs use three different communication strategies to address the issue
of CVD risk, depending on their perception of patient risk, motivation and anxiety. Absolute risk played a different
role within each strategy. Providing GPs with alternative ways of explaining absolute risk, in order to achieve
different communication aims, may improve their use of absolute CVD risk assessment in practice.