Feasibility of a behavioural health pilot project in general practice for patients with high cardiovascular disease risk: A qualitative study.

Conference:

SAPC ASM 2024 - Bristol

Talk Code:

6D.8

Presenter:

John Broughan

Twitter:

@broughan_john

Co-authors:

Emils Sietins1, Jiaran Gao1, Geoff McCombe1, John Broughan2, JT Treanor3, Janis Morrissey3, Mary Casey4, Joe Gallagher1, Patricia Fitzpatrick5, Orla Doyle6, Timothy Frawley4, Gerald Mills7, Tim Collins3, Walter Cullen1

Author institutions:

1School of Medicine, University College Dublin, Dublin, Ireland. 2Clinical Research Centre, School of Medicine, University College Dublin, Dublin, Ireland. 3The Irish Heart Foundation, Dublin, Ireland 4School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland. 5School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.

Problem

Cardiovascular disease (CVD) is the leading cause of death worldwide and disproportionately affects individuals from low socioeconomic (LSE) areas. Self-management interventions in general practice targeted towards people from LSE areas may positively impact patients’ health. The High-Risk Prevention Programme (HRPP), developed by the Ireland’s Health Service Executive (HSE), the Irish Heart Foundation and the University College Dublin School of Medicine is a behavioural self-management intervention promoting positive lifestyle changes for patients with high CVD risk. Six general practices from LSE areas in Ireland delivered the intervention. This study aimed to evaluate the acceptability and feasibility of the HRPP by employing qualitative methods to investigate the experiences of participating patients and healthcare staff.

Approach

The study’s qualitative method was guided by the Standards for Reporting Qualitative Research (SRQR) guidelines. Twenty-eight participants (18 patients and 10 healthcare staff) were interviewed. The intervention’s feasibility was assessed using Braun and Clarke’s Reflexive Thematic Analysis approach.

Findings

Four key themes were identified among patients: (1) motivation to change health behaviours, (2) practical benefits for patients, (3) challenges experiences by patients, and (4) lifestyle management and healthcare supports. Four themes were also identified among healthcare staff: (1) positive experience of the programme and its benefits, (2) logistical challenges, (3) patient engagement, and (4) programme management. These themes demonstrated that the HRPP showed high levels of acceptability and feasibility. Future studies should assess this intervention’s likely effectiveness and consider scaling-up the intervention by including younger patients and by thinking of ways to better manage the workload of healthcare staff responsible for delivering the intervention. Incorporation of the HRPP into the HSE’s nationwide ‘Chronic Disease Management Programme’ is advised.

Consequences

The findings may inform future research, policy, and practice. Future clinical /policy initiatives and research may implement and / or evaluate the HRPP model for interventions in non-GP community settings, or for other chronic conditions requiring self-management support (e.g., Type 2 diabetes, asthma, chronic obstructive pulmonary disease).

Submitted by:

John Broughan

Funding acknowledgement:

We are grateful to the Irish Heart Foundation and Ireland’s Health Service Executive for supporting this project. We would also like to thank the Health Research Board, University College Dublin, and the Ireland East Hospital Group for their support.