Rural-serving primary care practitioners' and cardiologists' care adaptations for cardiovascular services: A qualitative analysis.
| Title: | Rural-serving primary care practitioners' and cardiologists' care adaptations for cardiovascular services: A qualitative analysis. |
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| Authors: | Miller SG; Department of Global Health, University of Washington, Seattle, Washington, USA.; Burchim S; Department of Global Health, University of Washington, Seattle, Washington, USA.; Beima-Sofie K; Department of Global Health, University of Washington, Seattle, Washington, USA.; Spencer AG; Department of Global Health, University of Washington, Seattle, Washington, USA.; Wadden E; Department of Global Health, University of Washington, Seattle, Washington, USA.; Selah B; Department of Global Health, University of Washington, Seattle, Washington, USA.; Jaffari A; Department of Global Health, University of Washington, Seattle, Washington, USA.; Suchsland MZ; Department of Family Medicine, University of Washington, Seattle, Washington, USA.; Cole A; Department of Family Medicine, University of Washington, Seattle, Washington, USA.; Elrod S; Providence Chehalis, Chehalis, Washington, USA.; Gehring P; Kootenai Health St. Mary's Hospital, Cottonwood, Idaho, USA.; Gilles R; Kootenai Clinic Coeur d'Alene Family Medicine Residency, Coeur d'Alene, Idaho, USA.; Jose CG; PeaceHealth Ketchikan, Ketchikan, Alaska, USA.; McGrath K; Kootenai Health St. Mary's Hospital, Cottonwood, Idaho, USA.; Kootenai Health Clearwater Valley Hospital, Orofino, Idaho, USA.; Baker RT; School of Health and Medical Professions, University of Idaho, Moscow, Idaho, USA.; Longenecker CT; Department of Global Health, University of Washington, Seattle, Washington, USA. |
| Source: | The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association [J Rural Health] 2026 Jan; Vol. 42 (1), pp. e70129. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Blackwell Country of Publication: England NLM ID: 8508122 Publication Model: Print Cited Medium: Internet ISSN: 1748-0361 (Electronic) Linking ISSN: 0890765X NLM ISO Abbreviation: J Rural Health Subsets: MEDLINE |
| Imprint Name(s): | Publication: [Oxford, Eng.] : Blackwell; Original Publication: [Burlington, Vt.?] : Journal of Rural Health, c1985- |
| MeSH Terms: | Cardiologists*/psychology ; Cardiologists*/statistics & numerical data ; Rural Health Services*/standards; Interviews as Topic/methods ; Rural Population/statistics & numerical data ; Cardiovascular Diseases/therapy ; Humans ; Qualitative Research ; Female ; Male ; Primary Health Care ; Washington ; Idaho ; Alaska ; Middle Aged ; Adult |
| Abstract: | Purpose: Rural populations in the United States have less access to cardiovascular care relative to their urban counterparts while bearing a higher burden of heart disease. To understand rural patients' access to cardiovascular care services, we conducted a qualitative study investigating which cardiovascular services rural-serving primary care practitioners offered, how they adapted care, and what factors influenced cardiovascular scope of practice and adaptations among rural-serving primary care practitioners and cardiologists.; Methods: We conducted semi-structured interviews with rural-serving primary care physicians, advanced practice providers, and pharmacists, as well as cardiologists, in Alaska, Idaho, and Washington state.; Findings: Twenty health care practitioners participated in this study. We identified two themes characterizing cardiovascular services: expanded scope of practice (e.g., primary care physician prescribing a higher-risk anti-arrhythmic medication, dofetilide, for atrial fibrillation) and altered care (e.g., cardiologist ordering fewer cardiovascular imaging tests when needed technology was unavailable). Using a socio-ecological approach, we found factors affecting care adaptations at four levels: local communities; individual practitioners; local clinics and health systems; and the broader health care, law, and policy environment.; Conclusions: When caring for rural cardiovascular patients, primary care practitioners and referring cardiologists expanded their scope of practice and altered care. Multiple factors affected these shifts. Future research could address whether and how expansion of scope of practice (e.g., through team-based care) may improve access to cardiovascular care among rural populations.; (© 2026 The Author(s). The Journal of Rural Health published by Wiley Periodicals LLC on behalf of National Rural Health Association.) |
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| Grant Information: | #23HERNPRH1150364 American Heart Association; UL1TR002319 United States TR NCATS NIH HHS |
| Contributed Indexing: | Keywords: health equity; health workforce; qualitative; rural health; scope of practice |
| Entry Date(s): | Date Created: 20260217 Date Completed: 20260217 Latest Revision: 20260219 |
| Update Code: | 20260219 |
| PubMed Central ID: | PMC12910149 |
| DOI: | 10.1111/jrh.70129 |
| PMID: | 41699827 |
| Database: | MEDLINE |
Journal Article