ArticleBMJ open2016
Improving care for heart failure patients in primary care, GPs' perceptions: a qualitative evidence synthesis.
Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
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Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Mapping Evidence and Constructing an Analytic Framework: An Umbrella Review Summarizing Primary Care Family Physicians' Experiences With Clinical Integration.Annals of family medicine · 2025Pooled it
- Barriers to Protocol Adherence in Emergency Departments and Evidence-Based Strategies for Successful Implementation: A Scoping Review.Journal of clinical medicine · 2026Review
- Bridging the knowledge gap: assessing heart failure awareness and educational needs among clinical physicians.BMC primary care · 2026Article
- Geriatricians' perceptions on multidisciplinary heart failure care in Belgium an exploratory qualitative study.BMC health services research · 2026Article
- Prevention and Management of Heart Failure Associated with Type 2 Diabetics in Rural Australia.Journal of clinical medicine · 2025Review
- The Effect of an Incentive Billing Code on Heart Failure Management in Primary Care: A Population-Based Study.CJC open · 2025Article
- Initial high-doseFrontiers in cardiovascular medicine · 2025Article
- Diagnosing and managing patients with heart failure with preserved ejection fraction: a consensus survey.BMJ open · 2024Observational
- Successful use of point-of-care ultrasound for an elderly patient with heart failure in a primary care setting: a case report.European heart journal. Case reports · 2024Article
- Heart failure care in the Central and Eastern Europe and Baltic region: status, barriers, and routes to improvement.ESC heart failure · 2024Review
- Article
- Barriers and enablers to implementing clinical practice guidelines in primary care: an overview of systematic reviews.BMJ open · 2023Review
- Primary care heart failure service identifies a missed cohort of heart failure patients with reduced ejection fraction.European heart journal · 2022Article
- A qualitative analysis of the barriers and enablers faced by Australian rural general practitioners in the non-pharmacological management of congestive heart failure in community dwelling patients.BMC health services research · 2022Article
- Factors associated with the identification of drug therapy problems among older patients in Primary Health Care.Einstein (Sao Paulo, Brazil) · 2022Article
- Medical Treatment of Heart Failure with Reduced Ejection Fraction in the Elderly.Cardiac failure review · 2022Review
- Clinical inertia in the treatment of heart failure: a major issue to tackle.Heart failure reviews · 2021Review
- PRospective Evaluation of natriuretic peptide-based reFERral of patients with chronic heart failure in primary care (PREFER): a real-world study.Open heart · 2021Article
- First symptoms and health care pathways in hospitalized patients with acute heart failure: ICPS2 survey. A report from the Heart Failure Working Group (GICC) of the French Society of Cardiology.Clinical cardiology · 2021Observational
- Guideline Adherence of β-blocker Initiating Dose and its Consequence in Hospitalized Patients With Heart Failure With Reduced Ejection Fraction.Frontiers in pharmacology · 2021Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesGeneral practitioners (GPs) play a key role in heart failure (HF) management. Despite multiple guidelines, the management of patients with HF in primary care is suboptimal. Therefore, all the qualitative evidence concerning GPs' perceptions of managing HF in primary care was synthesised to identify barriers and facilitators for optimal care, and ideas for improvement.
designQualitative evidence synthesis.
methodsSearches of MEDLINE, EMBASE, Web of Science and CINAHL databases up to 20/12/2015 were conducted. The Critical Appraisal Skills Programme's checklist for qualitative research was used for quality assessment. Thematic analysis was used as method of analysis.
resultsOf 5427 articles, 18 qualitative articles were included. Findings were organised in HF-specific factors, patient factors, physician factors and contextual factors. GPs' uncertainty in all areas of HF management was highlighted. HF management started with an uncertain diagnosis, leading to difficulties with communication, treatment and advance care planning. Lack of access to specialised care and lack of knowledge were identified as important contributors to this uncertainty. In an effort to overcome this, strategies bringing evidence into practice should be promoted. GPs expressed the need for a multidisciplinary chronic care approach for HF. However, mixed experiences were noted with regard to interprofessional collaboration.
conclusionsThe main challenges identified in this synthesis were how to deal with GPs' uncertainty about clinical practice, how to bring evidence into practice and how to work together as a multiprofessional team. These barriers were situated predominantly on the physician and contextual level. Targets to improve GPs' HF care were identified.
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