Barriers to cardiovascular disease risk reduction: Does physicians' perspective matter?
BACKGROUND
Cardiovascular disease (CVD) is emerging as a major epidemic and the leading cause of death and disability in India. This study is an attempt to understand the barriers and challenges faced by physicians in CVD risk reduction in a rural setting.


METHODS
The study was conducted among 34 physicians across six randomly selected villages of Bangalore Rural District. Convergent parallel design was used to combine the strengths of qualitative and quantitative approaches to develop a stronger understanding of the experiences and challenges of practicing physicians in reducing the risk of CVD in this region. After concurrently collecting the data, rigorous procedures for both quantitative and qualitative methods were used independently and then merged to provide an enhanced understanding of the research question.


RESULTS
Lack of knowledge and understanding of the disease, myths and beliefs, attitude of the patients, non-adherence to lifestyle changes and medications, the chronic nature of the disease, financial constraints, and lack of national guidelines were identified as the major barriers.


CONCLUSIONS
This study highlights the challenges faced by physicians in dealing with the increasing number of patients presenting with CVD risk factors in rural areas. It also suggests options that could minimize these barriers, enabling them to manage their patients with CVD risk in the best way possible. It is critical to institute guidelines and algorithms to manage these risk factors in the rural Indian context.
Department of Community Health and Family Medicine, Bangalore Baptist Hospital, Hebbal, Bellary Road, Bangalore 560024, Karnataka, India. Electronic address: carolinelizabethj@gmail.com.
Carolin Elizabeth
CE
George
Department of Community Health and Family Medicine, Bangalore Baptist Hospital, Hebbal, Bellary Road, Bangalore 560024, Karnataka, India.
Dhanya
D
Ramadas
Professor and Head, Department of Community Health and Family Medicine, Bangalore Baptist Hospital, Hebbal, Bellary Road, Bangalore 560024, Karnataka, India.
Gift
G
Norman
Department of Community Health and Family Medicine, Bangalore Baptist Hospital, Hebbal, Bellary Road, Bangalore 560024, Karnataka, India.
Devashri
D
Mukherjee
Department of Community Health and Family Medicine, Bangalore Baptist Hospital, Hebbal, Bellary Road, Bangalore 560024, Karnataka, India.
Tata
T
Rao
D001291:Attitude of Health Personnel; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D002423:Cause of Death / Q000639:trends; D019468:Disease Management; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D010820:Physicians / Q000592:standards*; D012424:Rural Population
Cardiovascular disease; Convergent parallel design; Physicians; Risk factors