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Implementing cardiometabolic health checks in general practice: a qualitative process evaluation

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Implementing cardiometabolic health checks in general practice: a qualitative process evaluation. / Godefrooij, M.; Spigt, M.; van der Minne, W.; Jurrissen, G.; Dinant, G.J.; Knottnerus, A.

In: BMC Family Practice, Vol. 15, 132, 06.07.2014.

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@article{1005b19b812d47fab476bd0ad155f297,
title = "Implementing cardiometabolic health checks in general practice: a qualitative process evaluation",
abstract = "Background: A stepwise screening approach for the detection and management of cardiometabolic disease is proposed in various primary care guidelines. The aim of this study was to explore the implementation of a cardiometabolic health check as perceived by the involved caregivers and patients.Methods: Qualitative process evaluation of the implementation of a cardiometabolic screening programme in a multidisciplinary primary healthcare centre in Eindhoven, the Netherlands, in which 1270 patients had participated. We explored the caregivers' experiences though focus group discussions and collected patients' experiences through a written questionnaire containing two open-ended questions. We analyzed our data using a thematic content analysis based on grounded theory principles.Results: Five general practitioners, three practice nurses and five medical receptionists participated in the focus groups. Additionally we collected experiences of 657 (52{\%} of 1270) participating patients through an open-ended questionnaire.GPs were enthusiastic about offering a health check and preferred systematic screening over case-finding, both in terms of yield and workload. The level of patient participation was high and most participants were enthusiastic about the health check being offered by their GP. Despite their enthusiasm, the GPs realized that they lacked experience in the design and implementation of a structured, large-scale prevention programme. This resulted in suboptimal instruction of the involved practice nurses and medical receptionists. The recruitment strategy was unnecessarily aggressive. There were shortcomings in communicating the outcomes of the health check to the patients and there was no predefined follow-up programme. Based on our findings we developed a checklist that can be used by designers of similar health checks.Conclusions: A number of fundamental issues may arise when GPs organize a systematic screening programme in their practice. These issues are related to the preparation of the involved staff, the importance of integration with everyday clinical practice, the approach of healthy patients and the provision of adequate follow-up programmes. The identified challenges and recommendations can be taken into account during future screening programmes.",
keywords = "Primary health care, General practice, Cardiovascular disease, Diabetes, Kidney disease, Mass screening, PREVENTION, BARRIERS, IMPROVEMENT, ILLNESS, RISK",
author = "M. Godefrooij and M. Spigt and {van der Minne}, W. and G. Jurrissen and G.J. Dinant and A. Knottnerus",
year = "2014",
month = "7",
day = "6",
doi = "10.1186/1471-2296-15-132",
language = "English",
volume = "15",
journal = "BMC Family Practice",
issn = "1471-2296",
publisher = "BioMed Central Ltd",

}

RIS

TY - JOUR

T1 - Implementing cardiometabolic health checks in general practice: a qualitative process evaluation

AU - Godefrooij, M.

AU - Spigt, M.

AU - van der Minne, W.

AU - Jurrissen, G.

AU - Dinant, G.J.

AU - Knottnerus, A.

PY - 2014/7/6

Y1 - 2014/7/6

N2 - Background: A stepwise screening approach for the detection and management of cardiometabolic disease is proposed in various primary care guidelines. The aim of this study was to explore the implementation of a cardiometabolic health check as perceived by the involved caregivers and patients.Methods: Qualitative process evaluation of the implementation of a cardiometabolic screening programme in a multidisciplinary primary healthcare centre in Eindhoven, the Netherlands, in which 1270 patients had participated. We explored the caregivers' experiences though focus group discussions and collected patients' experiences through a written questionnaire containing two open-ended questions. We analyzed our data using a thematic content analysis based on grounded theory principles.Results: Five general practitioners, three practice nurses and five medical receptionists participated in the focus groups. Additionally we collected experiences of 657 (52% of 1270) participating patients through an open-ended questionnaire.GPs were enthusiastic about offering a health check and preferred systematic screening over case-finding, both in terms of yield and workload. The level of patient participation was high and most participants were enthusiastic about the health check being offered by their GP. Despite their enthusiasm, the GPs realized that they lacked experience in the design and implementation of a structured, large-scale prevention programme. This resulted in suboptimal instruction of the involved practice nurses and medical receptionists. The recruitment strategy was unnecessarily aggressive. There were shortcomings in communicating the outcomes of the health check to the patients and there was no predefined follow-up programme. Based on our findings we developed a checklist that can be used by designers of similar health checks.Conclusions: A number of fundamental issues may arise when GPs organize a systematic screening programme in their practice. These issues are related to the preparation of the involved staff, the importance of integration with everyday clinical practice, the approach of healthy patients and the provision of adequate follow-up programmes. The identified challenges and recommendations can be taken into account during future screening programmes.

AB - Background: A stepwise screening approach for the detection and management of cardiometabolic disease is proposed in various primary care guidelines. The aim of this study was to explore the implementation of a cardiometabolic health check as perceived by the involved caregivers and patients.Methods: Qualitative process evaluation of the implementation of a cardiometabolic screening programme in a multidisciplinary primary healthcare centre in Eindhoven, the Netherlands, in which 1270 patients had participated. We explored the caregivers' experiences though focus group discussions and collected patients' experiences through a written questionnaire containing two open-ended questions. We analyzed our data using a thematic content analysis based on grounded theory principles.Results: Five general practitioners, three practice nurses and five medical receptionists participated in the focus groups. Additionally we collected experiences of 657 (52% of 1270) participating patients through an open-ended questionnaire.GPs were enthusiastic about offering a health check and preferred systematic screening over case-finding, both in terms of yield and workload. The level of patient participation was high and most participants were enthusiastic about the health check being offered by their GP. Despite their enthusiasm, the GPs realized that they lacked experience in the design and implementation of a structured, large-scale prevention programme. This resulted in suboptimal instruction of the involved practice nurses and medical receptionists. The recruitment strategy was unnecessarily aggressive. There were shortcomings in communicating the outcomes of the health check to the patients and there was no predefined follow-up programme. Based on our findings we developed a checklist that can be used by designers of similar health checks.Conclusions: A number of fundamental issues may arise when GPs organize a systematic screening programme in their practice. These issues are related to the preparation of the involved staff, the importance of integration with everyday clinical practice, the approach of healthy patients and the provision of adequate follow-up programmes. The identified challenges and recommendations can be taken into account during future screening programmes.

KW - Primary health care

KW - General practice

KW - Cardiovascular disease

KW - Diabetes

KW - Kidney disease

KW - Mass screening

KW - PREVENTION

KW - BARRIERS

KW - IMPROVEMENT

KW - ILLNESS

KW - RISK

U2 - 10.1186/1471-2296-15-132

DO - 10.1186/1471-2296-15-132

M3 - Article

VL - 15

JO - BMC Family Practice

T2 - BMC Family Practice

JF - BMC Family Practice

SN - 1471-2296

M1 - 132

ER -