SEARCHCROSS-SECTIONALcardiology, obstetrics and gynecology

cross-sectional·cardiology, obstetrics and gynecology, family medicine, public health, epidemiology·PMC10490358

Barriers and Facilitators to Cardiovascular Disease Prevention Following Hypertensive Disorders of Pregnancy in Primary Care: Cross-Sectional Surveys

Nutrients · 6 authors, 4 centres

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This study used separate cross-sectional online surveys to describe practices, barriers, and facilitators for cardiovascular disease (CVD) preventative care in primary care for women after hypertensive disorders of pregnancy (HDP). The surveys included 35 general practitioners (GPs) and 105 women with a history of HDP. Both groups identified barriers, including GP lack of skills/resources and women's difficulty accessing appointments. Strategies to improve care were aligned between groups, focusing on increasing women's awareness of CVD risk and improving communication between hospitals and primary care. Limitations include a small, predominantly female GP sample and potential effects of the COVID-19 pandemic on survey timing and response rates.

STUDY TYPE

cross-sectional

SPECIALTY

cardiology

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ORIGINAL PAPER

PMC10490358

Barriers and Facilitators to Cardiovascular Disease Prevention Following Hypertensive Disorders of Pregnancy in Primary Care: Cross-Sectional Surveys

Nutrients

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ABSTRACT

Women with a history of hypertensive disorders of pregnancy (HDP) have an increased risk of cardiovascular disease (CVD). Guidelines recommend that women diagnosed with HDP should be advised of their increased CVD risk, have regular blood pressure monitoring by their general practitioner (GP), and adopt healthy lifestyle behaviours. However, within Australia, the current practice in primary health care is unknown. The aim of this study was to describe current practices, barriers, and facilitators to the provision of CVD preventative services for women after HDP in the primary care setting and to identify potential strategies to support GPs in providing recommended care. Separate cross-sectional online surveys were undertaken with 35 GPs and 105 women with a history of HDP. Surveys included both closed- and open-ended questions. Closed-ended questions were analysed using basic descriptive statistics, and open-ended questions were themed and tallied. The survey of GPs revealed that GPs are more likely to assess traditional CVD risk markers than lifestyle risk factors or HDP history. GPs identified a lack of resources and skills as barriers to providing CVD preventative care post-HDP. The survey with women after HDP revealed that women with a history of HDP are more likely to be assessed for blood pressure than lifestyle CVD risk factors, and that the women’s barriers to obtaining care included difficulty obtaining an appointment and time required for attending appointments. Strategies to improve CVD preventative care were consistent between surveys, where 70% of GPs and 59% of women chose ‘increasing women’s awareness of increased CVD risk’ and 67% of GPs and 55% of women chose ‘improving communication between hospitals and primary care’ as their preferred strategies. While the findings suggest that women with a history of HDP are receiving advice consistent with guidelines for traditional CVD risk markers, such as blood pressure, they are less likely to receive CVD preventative care for lifestyle or female-specific CVD risk factors.

CITATION EXPORT

Kaylee Slater, Rachael Taylor, Karen McLaughlin et al.. Barriers and Facilitators to Cardiovascular Disease Prevention Following Hypertensive Disorders of Pregnancy in Primary Care: Cross-Sectional Surveys. Nutrients. (2023). https://doi.org/10.3390/nu15173817

AUTHORS

6 · 4 CENTRES

Kaylee Slater, Rachael Taylor, Karen McLaughlin, Craig Pennell, Clare Collins, Melinda Hutchesson

1School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; [email protected] (K.S.); [email protected] (R.T.); [email protected] (C.C.)
2Food and Nutrition Research Program, Hunter Medical Research Institute, Lot 1, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
3School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; [email protected]
4School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; [email protected]

EDITOR / REVIEWER

Bruce W. Hollis, Ornoy Asher