Table 7 Summary of reasons given by GPs for reassessment and monitoring intervals
Shorter monitoring and/or reassessment period (<6 | Longer monitoring and/or reassessment period (6+ months) |
|---|---|
Patient drivers • Low patient motivation to make lifestyle changes – may need to start medication earlier. • High patient motivation to make lifestyle changes – maintain motivation with good results. • Patient desires frequent monitoring and reassessment Risk factor drivers • Borderline for treatment with medication • Monitoring of blood pressure and cholesterol after lifestyle change prescription • Comorbidities • Weight monitoring • Smokers: frequent monitoring of other risk factors and opportunities to reassess willingness to quit. GP drivers • Strong focus on prevention/screening • Strong focus on reducing risk through lifestyle change rather than medication • View that you can monitor more often than recommended by guidelines without over-servicing | Patient drivers • High patient motivation - patient is motivated by early success with lifestyle change and can manage alone for longer intervals. • Longer time period needed for lifestyle changes to show results, in order not to discourage or demotivate patient with lack of success. Risk factor drivers • Risk factors have decreased or are well controlled with medication • No urgent CVD risk factors that need to be addressed, and/or absolute risk is low GP drivers • Too busy to reassess CVD risk unless requested by patient • Use of opportunistic monitoring and reassessment • Follow guideline recommendations on reassessment and monitoring frequency for low/moderate risk patients • Concern about over-servicing asymptomatic patients • Involvement of other practitioners in patient’s care (dietician, exercise physiologist, etc.) |