Understanding physicians’ perceived barriers to screening and patient education to reduce stroke risk in community health centers in Indonesia

BackgroundStroke is the leading cause of death in Indonesia and correspondingly the prevalence of stroke risk factors is high. Improved risk factor screening along with education and counseling for patients on the behavior changes that they need to make to reduce their stroke risk have the potential to lessen stroke burden.MethodsFocus groups were conducted with physicians working in community health centers (puskesmas) in Indonesia to explore physicians’ practices with regard to stroke risk screening and patient education to reduce stroke risk.ResultsPhysicians perceive that patients commonly have misconceptions about their stroke risk factors, indicating a need for patient education. Screening and education practices vary considerably among Indonesian primary care physicians, suggesting a need for physicians to improve their patient education and counseling practices. Physicians reported lack of time during appointments, as well as their perceptions of patients’ reluctance to modify their behaviors and patients’ low level of education as barriers to patient education for stroke prevention.ConclusionPhysicians reported knowledge, attitudinal, and health care system barriers that need to be addressed as part of interventions aimed at improving stroke screening and patient education and counseling in this setting.