“Patients would probably be more compliant to therapy if encouraged by those around them”: a qualitative study exploring primary care physicians’ perceptions on barriers to CVD risk management

BACKGROUND: Public health prevention strategies have been developed to overcome the disease burden. Despite all the available resources, there have been several challenges in keeping up with the practices in Cardiovascular Diseases (CVD) risk management. The aim of this study is to explore Primary Care Physicians’ (PCP) perceptions on barriers to CVD risk management and strategies to overcome these barriers in Suva, Fiji. METHODS: This is a qualitative study conducted in the Suva Medical area among 7 health centers from August 1st to September 30th, 2021. Purposive sampling was used to recruit participants who provided in-depth and detailed information. From those physicians who worked in the Suva medical area as Primary Health Care (PHC) physicians, those who had at least 6 months experience and those who had some Special Outpatients Department (SOPD) exposure, in-depth interview was conducted using semi-structured questionnaire over the telephone and recorded in a mobile app. The interview content was then transcribed and thematic analysis was done. RESULTS: This study included 25 PHC physicians. From the thematic analysis, 2 major themes were developed including perceived barriers to CVD risk management and some of the strategies to overcome these barriers. Some of the barriers identified include patient factors such as non-compliance, physician factors such as time-constraints and lack of training, and health system factors such as poor medical records system and lack of basic resource. The strategic support systems include patient expectations, physician’s encouragement, utilization of resources, laws and legislations and continuing evidence-based medicine. CONCLUSIONS: Physicians’ perceptions on the barriers and the strategies to overcome those barriers in CVD risk management plays an important role. The barriers include those of physician factors, patient factors and the health system as a whole. It is suggested to encourage shared-decision making in CVD management, enhance physician support and reinforce policies and research to bring about positive change and improvements in the quality of care.