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Barriers and facilitators among health professionals in primary care to prevention of cardiometabolic diseases: A systematic review
Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Family Med & Primary Care, Huddinge, Sweden.
Univ Med Ctr, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands.
Karolinska Univ Hosp, Funct Area Emergency Med, Stockholm, Sweden;Karolinska Inst, Dept Internal Med, Stockholm, Sweden.
Karolinska Inst, Univ Lib, Stockholm, Sweden.
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2018 (English)In: Family Practice, ISSN 0263-2136, E-ISSN 1460-2229, Vol. 35, no 4, p. 383-398Article, review/survey (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Oxford University Press, 2018. Vol. 35, no 4, p. 383-398
Keywords [en]
Coronary heart disease, diabetes, general practitioner, health check, myocardial infarction, selective prevention, stroke
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-366457DOI: 10.1093/fampra/cmx137ISI: 000439794800006PubMedID: 29385438OAI: oai:DiVA.org:uu-366457DiVA, id: diva2:1265224
Available from: 2018-11-22 Created: 2018-11-22 Last updated: 2018-11-22Bibliographically approved

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