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Barriers to lifestyle risk factor assessment and management in hypertension: a qualitative study of Australian general practitioners

Journal of Human Hypertension volume 27, pages 474–478 (2013)Cite this article

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Abstract

Hypertension is a leading cause of mortality and disease burden worldwide, yet its management remains suboptimal. Identification and management of lifestyle risk factors should be a clinical priority in all patients because of the beneficial effects of lifestyle intervention on blood pressure. The objective of this qualitative focus group study was to identify barriers to lifestyle management in hypertension in Australian general practice. Purposeful sampling was used to select large group practices. Six focus groups (n=30) were audio recorded and transcribed. An iterative thematic analysis was conducted. Overall participants felt they had the required knowledge to provide broad lifestyle advice. However, cynicism dominated due to an overwhelming lack of success in practice. Patient reluctance and ambivalence were identified as major barriers but participants were willing to share the responsibility. Other barriers included time, reduced access to allied health and broader determinants of health. General practitioners need to be empowered to allow continuation of valuable lifestyle advice and counselling. The results emphasise the importance of ongoing lifestyle assessment and tailoring of management to the complex interplay of factors that impact on a patient’s ability to adopt and maintain lifestyle change. System issues need to be addressed to provide better streamlined care.

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Acknowledgements

This work was supported by the Royal Australian College of General Practitioners Research Foundation through a Cardiovascular Research Grant in General Practice and the National Heart Foundation of Australia through a Post Graduate Clinical Scholarship. The project was approved by the Human Research Ethics Committee (Tasmania) Network (approval number H9301). We thank Dr Emily Hansen (ECH) for her mentorship and assistance with the analysis of the original study and the general practitioners who participated in this study.

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Authors and Affiliations

  1. Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia

    F Howes, E Warnecke & M Nelson

  2. School of Medicine, University of Tasmania, Hobart, Tasmania, Australia

    F Howes, E Warnecke & M Nelson

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  1. F Howes
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Correspondence to F Howes.

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Howes, F., Warnecke, E. & Nelson, M. Barriers to lifestyle risk factor assessment and management in hypertension: a qualitative study of Australian general practitioners. J Hum Hypertens 27, 474–478 (2013). https://doi.org/10.1038/jhh.2013.9

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