A qualitative analysis of the barriers and enablers faced by Australian rural general practitioners in the non-pharmacological management of congestive heart failure in community dwelling patients

BMC Health Services Research

Jo Longman¹  David Pires²  Olivia Feng²  Trevor Kwan²  Benjamin Chua²  Natalie Edmiston³ 

[1] University Centre for Rural Health, Lismore, New South Wales, Australia;The University of Sydney, Sydney, New South Wales, Australia;Western Sydney University, Penrith, New South Wales, Australia;Western Sydney University, Penrith, New South Wales, Australia;University Centre for Rural Health, Lismore, New South Wales, Australia;

关键词: General practice;    Barriers;    Enablers;    Non-pharmacological management;    Congestive heart failure;    Rural Australia;   

DOI  :  10.1186/s12913-021-07383-3

来源: Springer

【 摘 要 】

BackgroundCongestive heart failure (CHF) is a significant health problem in Australia, and disproportionately affects rural Australians. Management of CHF in Australia is heavily centred around the general practitioner (GP). Australian and international literature indicates there is a gap between current and best practice in CHF management. There is little known about the non-pharmacological aspects of management, or CHF management in a rural Australian context. This study aimed to identify what Australian GPs practicing in the Northern Rivers Region of New South Wales, Australia, perceived were the barriers and enablers in the non-pharmacological management of CHF amongst community dwelling patients, to inform healthcare access, resourcing and delivery in Australian rural environments.MethodsQualitative study involving a realist thematic analysis of data collected from semi-structured face-to-face interviews.ResultsFifteen GPs and GP trainees participated. Four interlinked key themes underpinning GPs’ experiences with non-pharmacological management of CHF were interpreted from the interview data: (1) resources, (2) complexity of heart failure, (3) relationships, and (4) patient demographics, priorities and views affect how patients engage with non-pharmacological management of CHF.ConclusionRural Australian GPs face considerable barriers to non-pharmacological management of CHF. The data suggests that increased rural Australian health services and community transportation, multidisciplinary management, and stronger professional networks have the potential to be invaluable enablers of CHF management. Further research exploring non-pharmacological management of CHF in other rural contexts may provide additional insights to better inform rural healthcare access and resourcing.

【 授权许可】

CC BY