Presentation (CTI)

OBJECTIVES: The Hong Kong Reference Framework (RF) for Preventive Care for Older Adults in Primary Care provides evidence-based guidelines to enhance preventive care. However, its adoption and feasibility among primary care physicians (PCPs) remain unclear. This study evaluates PCPs’ awareness, adoption, and perceived barriers and enablers to RF implementation.
METHODS: A cross-sectional survey was conducted among 484 PCPs across different practice settings. The questionnaire assessed demographics, adoption of RF recommendations, and perceptions of implementation barriers and enablers. Logistic regression was used to identify key factors influencing RF appropriateness, acceptability, and feasibility.
RESULTS: Among 484 respondents, 49.59% practiced in private settings, and 23.76% had 21-25 years of experience. the most frequently adopted recommendations from the RF included seasonal influenza vaccination (450/484, 93.98%), routine tobacco use screening (430/484, 88.84%), and annual hypertension screening (429/484, 88.64%). In contrast, certain recommendations were rarely implemented, with 401/484 (82.85%) physicians seldom or never conducting opportunistic screening for urinary incontinence and 390/484 (80.58%) infrequently recommending opportunistic screening for hearing impairment. About 66% (≥320/484) acknowledged guideline-related barriers, primarily resource constraints and clinical integration challenges. Perceived lack of allied health support (p<0.001) and difficulty integrating RF into clinical practice (p<0.001) significantly affected appropriateness. Acceptability was influenced by consultation time limitations (p=0.022), while feasibility was associated with the inclusion of essential clinical information (p=0.005).
CONCLUSIONS: Despite broad support for RF recommendations, practical barriers hinder full implementation. Strengthening allied health support, improving workflow integration, and addressing time constraints may enhance adoption in primary care.