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Barriers and facilitators among health professionals in primary care to prevention of cardiometabolic diseases : A systematic review

Waendell, Per E. (author)
Karolinska Institutet
de Waard, Anne-Karien M. (author)
Univ Med Ctr, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands
Holzmann, Martin J. (author)
Karolinska Institutet
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Gornitzki, Carl (author)
Karolinska Institutet
Lionis, Christos (author)
Univ Crete, Sch Med, Clin Social & Family Med, Iraklion, Greece
de Wit, Niek (author)
Univ Med Ctr, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands
Sondergaard, Jens (author)
Univ Southern, Inst Publ Hlth, Res Unit Gen Practice, Odense, Denmark
Sonderlund, Anders L. (author)
Charles Univ Prague, Fac Med 1, Dept Gen Practice, Prague, Czech Republic
Kral, Norbert (author)
NIVEL Netherlands Inst Hlth Serv Res, Utrecht, Netherlands
Seifert, Bohumil (author)
NIVEL Netherlands Inst Hlth Serv Res, Utrecht, Netherlands
Korevaar, Joke C. (author)
Vrije Univ Amsterdam Med Ctr, Amsterdam Publ Hlth Res Inst, Dept Gen Practice & Elderly Care Med, Amsterdam, Netherlands
Schellevis, Francois G. (author)
Vrije Univ Amsterdam Med Ctr, Amsterdam Publ Hlth Res Inst, Dept Gen Practice & Elderly Care Med, Amsterdam, Netherlands
Carlsson, Axel C (author)
Karolinska Institutet,Uppsala universitet,Kardiovaskulär epidemiologi,Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Family Med & Primary Care, Huddinge, Sweden
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 (creator_code:org_t)
2018-01-29
2018
English.
In: Family Practice. - : Oxford University Press. - 0263-2136 .- 1460-2229. ; 35:4, s. 383-398
  • Research review (peer-reviewed)
Abstract Subject headings
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  • The aim of this study is to identify potential facilitators and barriers for health care professionals to undertake selective prevention of cardiometabolic diseases (CMD) in primary health care. We developed a search string for Medline, Embase, Cinahl and PubMed. We also screened reference lists of relevant articles to retain barriers and facilitators for prevention of CMD. We found 19 qualitative studies, 7 quantitative studies and 2 mixed qualitative and quantitative studies. In terms of five overarching categories, the most frequently reported barriers and facilitators were as follows: Structural (barriers: time restraints, ineffective counselling and interventions, insufficient reimbursement and problems with guidelines; facilitators: feasible and effective counselling and interventions, sufficient assistance and support, adequate referral, and identification of obstacles), Organizational (barriers: general organizational problems, role of practice, insufficient IT support, communication problems within health teams and lack of support services, role of staff, lack of suitable appointment times; facilitators: structured practice, IT support, flexibility of counselling, sufficient logistic/practical support and cooperation with allied health staff/community resources, responsibility to offer and importance of prevention), Professional (barriers: insufficient counselling skills, lack of knowledge and of experience; facilitators: sufficient training, effective in motivating patients), Patient-related factors (barriers: low adherence, causes problems for patients; facilitators: strong GP-patient relationship, appreciation from patients), and Attitudinal (barriers: negative attitudes to prevention; facilitators: positive attitudes of importance of prevention). We identified several frequently reported barriers and facilitators for prevention of CMD, which may be used in designing future implementation and intervention studies.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)

Keyword

Coronary heart disease
diabetes
general practitioner
health check
myocardial infarction
selective prevention
stroke

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