Key Points
- To examine the beliefs, clinical practices, and decision-making processes of general practitioners to identify barriers to effective heart failure diagnosis and management in primary care.
- Conducted a qualitative focus group study with 30 general practitioners (N=30) across four primary care groups in North East England using stratified, purposive sampling.
- Transcribed and analyzed interview discussions using a pragmatic variant of grounded theory.
- General practitioners reported diagnostic uncertainty and reluctance to prescribe evidence-based therapies (angiotensin-converting enzyme inhibitors, beta blockers, and spironolactone) due to concerns about patient frailty, comorbidity, and polypharmacy.
- Clinicians expressed doubts regarding the applicability of trial evidence to routine primary care and reported feeling overwhelmed by rapid therapeutic updates.
- Systemic barriers—including limited access to echocardiography, restricted cardiologist availability, and poor primary-secondary care coordination—further impeded guideline-directed care.
Structured PICO
PPopulation30 general practitioners from four primary care groups in North east England
OOutcomeBeliefs, current practices, and decision making of general practitioners in the diagnosis and management of suspected heart failure
General practitioners face significant barriers in diagnosing and managing heart failure, including clinical uncertainty and organizational factors, indicating that single strategies like guidelines are insufficient to improve care.