Barriers to implementing cardiovascular risk tables in routine general practice

Ben van Steenkiste; Trudy van der Weijden; Henri E J H Stoffers; Richard Grol

doi:10.1080/02813430310004489

Barriers to implementing cardiovascular risk tables in routine general practice

Ben van Steenkiste^*
, Trudy van der Weijden
, Henri E J H Stoffers
, Richard Grol

^*Corresponding author for this work

CAPHRI - Care and Public Health Research Institute

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

DESIGN: Qualitative study. GPs were interviewed after analysing two audiotaped cardiovascular consultations.

SETTING: Primary health care.

SUBJECTS: A sample of 15 GPs who audiotaped 22 consultations.

MAIN OUTCOME MEASURES: Barriers hampering GPs from following the guideline.

RESULTS: Data saturation was reached after about 13 interviews. The 25 identified barriers were related to the risk table, the GP or to environmental factors. Lack of knowledge and poor communication skills of the GP, along with pressure of work and demanding patients, cause GPs to deviate from the guideline. GPs regard barriers external to themselves as most important.

CONCLUSION: Using the risk table as a key element of the high-risk approach in primary prevention encounters many barriers. Merely incorporating risk tables in guidelines is not sufficient for implementation of the guidelines. Time-efficient implementation strategies dealing in particular with the communication and presentation of cardiovascular risk are needed.

Original language	English
Pages (from-to)	32-7
Number of pages	6
Journal	Scandinavian Journal of Primary Health Care
Volume	22
Issue number	1
DOIs	https://doi.org/10.1080/02813430310004489
Publication status	Published - Mar 2004

Keywords

Adolescent
Adult
Aged
Cardiovascular Diseases/etiology
Clinical Competence
Family Practice/standards
Female
Guideline Adherence/statistics & numerical data
Humans
Interviews as Topic
Male
Middle Aged
Netherlands
Practice Guidelines as Topic
Primary Health Care/standards
Qualitative Research
Quality Assurance, Health Care
Risk Assessment/statistics & numerical data
Risk Factors

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10.1080/02813430310004489

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Cite this

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title = "Barriers to implementing cardiovascular risk tables in routine general practice",

abstract = "DESIGN: Qualitative study. GPs were interviewed after analysing two audiotaped cardiovascular consultations.SETTING: Primary health care.SUBJECTS: A sample of 15 GPs who audiotaped 22 consultations.MAIN OUTCOME MEASURES: Barriers hampering GPs from following the guideline.RESULTS: Data saturation was reached after about 13 interviews. The 25 identified barriers were related to the risk table, the GP or to environmental factors. Lack of knowledge and poor communication skills of the GP, along with pressure of work and demanding patients, cause GPs to deviate from the guideline. GPs regard barriers external to themselves as most important.CONCLUSION: Using the risk table as a key element of the high-risk approach in primary prevention encounters many barriers. Merely incorporating risk tables in guidelines is not sufficient for implementation of the guidelines. Time-efficient implementation strategies dealing in particular with the communication and presentation of cardiovascular risk are needed.",

keywords = "Adolescent, Adult, Aged, Cardiovascular Diseases/etiology, Clinical Competence, Family Practice/standards, Female, Guideline Adherence/statistics \& numerical data, Humans, Interviews as Topic, Male, Middle Aged, Netherlands, Practice Guidelines as Topic, Primary Health Care/standards, Qualitative Research, Quality Assurance, Health Care, Risk Assessment/statistics \& numerical data, Risk Factors",

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year = "2004",

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doi = "10.1080/02813430310004489",

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AU - van Steenkiste, Ben

AU - van der Weijden, Trudy

AU - Stoffers, Henri E J H

AU - Grol, Richard

PY - 2004/3

Y1 - 2004/3

N2 - DESIGN: Qualitative study. GPs were interviewed after analysing two audiotaped cardiovascular consultations.SETTING: Primary health care.SUBJECTS: A sample of 15 GPs who audiotaped 22 consultations.MAIN OUTCOME MEASURES: Barriers hampering GPs from following the guideline.RESULTS: Data saturation was reached after about 13 interviews. The 25 identified barriers were related to the risk table, the GP or to environmental factors. Lack of knowledge and poor communication skills of the GP, along with pressure of work and demanding patients, cause GPs to deviate from the guideline. GPs regard barriers external to themselves as most important.CONCLUSION: Using the risk table as a key element of the high-risk approach in primary prevention encounters many barriers. Merely incorporating risk tables in guidelines is not sufficient for implementation of the guidelines. Time-efficient implementation strategies dealing in particular with the communication and presentation of cardiovascular risk are needed.

AB - DESIGN: Qualitative study. GPs were interviewed after analysing two audiotaped cardiovascular consultations.SETTING: Primary health care.SUBJECTS: A sample of 15 GPs who audiotaped 22 consultations.MAIN OUTCOME MEASURES: Barriers hampering GPs from following the guideline.RESULTS: Data saturation was reached after about 13 interviews. The 25 identified barriers were related to the risk table, the GP or to environmental factors. Lack of knowledge and poor communication skills of the GP, along with pressure of work and demanding patients, cause GPs to deviate from the guideline. GPs regard barriers external to themselves as most important.CONCLUSION: Using the risk table as a key element of the high-risk approach in primary prevention encounters many barriers. Merely incorporating risk tables in guidelines is not sufficient for implementation of the guidelines. Time-efficient implementation strategies dealing in particular with the communication and presentation of cardiovascular risk are needed.

KW - Adolescent

KW - Adult

KW - Aged

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KW - Clinical Competence

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KW - Female

KW - Guideline Adherence/statistics & numerical data

KW - Humans

KW - Interviews as Topic

KW - Male

KW - Middle Aged

KW - Netherlands

KW - Practice Guidelines as Topic

KW - Primary Health Care/standards

KW - Qualitative Research

KW - Quality Assurance, Health Care

KW - Risk Assessment/statistics & numerical data

KW - Risk Factors

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DO - 10.1080/02813430310004489

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SP - 32

EP - 37

JO - Scandinavian Journal of Primary Health Care

JF - Scandinavian Journal of Primary Health Care

IS - 1

ER -

Barriers to implementing cardiovascular risk tables in routine general practice

Abstract

Keywords

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