The DOI matches its Crossref record; 21 of the 21 references it cites were found in a registry or an index.
Barriers to implementing cardiovascular risk tables in routine general practice
Open accessAbstract
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.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“A Dutch qualitative study of the use of risk tables as a key component of risk assessments for primary prevention reported that physicians' knowledge of the risk tables and ability to communicate that knowledge to the patient influenced their implementation.545”
From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [545]
In the citing paper
“Physicians are also concerned about overestimating risk in national populations, which may lead to overuse of medical therapy.545,547”
From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [545]
In the citing paper
“The length of routine patient consultations, which provides little time for discussion, is widely recognized as a barrier to conducting risk assessments.545,547”
From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [545]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Primary Care: Is There Enough Time for Prevention?
Yarnall, K. S. H., Pollak, K. I., Østbye, T., Krause, K. M., & Michener, J. L. (2003) · American Journal of Public Health · doi:10.2105/ajph.93.4.635 · Cited by 1,641 · cited 1×
“Complying with all guidelines on primary prevention would take several hours a day (15).”
Grundy, S. M., Pasternak, R., Greenland, P., Smith, S., & Fuster, V. (1999) · Circulation · doi:10.1161/01.cir.100.13.1481 · Cited by 1,315
Wood, D., Backer, G. D., Færgeman, O., Graham, I. D., Mancia, G., & Pyörälà, K. (1998) · Atherosclerosis · doi:10.1016/s0021-9150(98)90209-x · Cited by 1,253
Prevention of coronary heart disease in clinical practice
Pyörälà, K., Backer, G. D., Graham, I. M., Poole-Wilson, P. A., & Wood, D. A. (1994) · European Heart Journal · doi:10.1093/oxfordjournals.eurheartj.a060388 · Cited by 1,161
Why general practitioners do not implement evidence: qualitative study
Freeman, A., & Sweeney, K. (2001) · BMJ · doi:10.1136/bmj.323.7321.1100 · Cited by 397
Montgomery, A. A. (2000) · BMJ · doi:10.1136/bmj.320.7236.686 · Cited by 279
Updated New Zealand cardiovascular disease risk-benefit prediction guide
Jackson, R. (2000) · BMJ · doi:10.1136/bmj.320.7236.709 · Cited by 229
Haq, I. U., Ramsay, L. E., Yeo, W. W., Jackson, P., & Wallis, E. J. (1999) · Heart · doi:10.1136/hrt.81.1.40 · Cited by 214
Marteau, T. M., & Kinmonth, A. L. (2002) · BMJ · doi:10.1136/bmj.325.7355.78 · Cited by 149
Fairhurst, K., & Huby, G. Ø. (1998) · BMJ · doi:10.1136/bmj.317.7166.1130 · Cited by 141
Communicating the risk reduction achieved by cholesterol reducing drugs
Skolbekken, J. (1998) · BMJ · doi:10.1136/bmj.316.7149.1956 · Cited by 118
Isles, C. (2000) · BMJ · doi:10.1136/bmj.320.7236.690 · Cited by 51
Barriers to preventive care in general practice: the role of organizational and attitudinal factors.
Hulscher, M., Drenth, B. B. V., Mokkink, H. G. A., van der Wouden, J. C., & Grol, R. P. T. M. (1997) · Europe PMC (PubMed Central) · Cited by 46
Self-citationThe effect of physician characteristics on compliance with adult preventive care guidelines.
Ely, J., Goerdt, C. J., BERGUS, G. R., West, C. P., Dawson, J. D., & Doebbeling, B. N. (1998) · PubMed · Cited by 39
Measuring academic production.
Scheid, D. C., Hamm, R. M., & Crawford, S. A. (2002) · PubMed · Cited by 27
Paterson, J. M., Llewellyn‐Thomas, H. A., & Naylor, C. D. (2002) · Health Expectations · doi:10.1046/j.1369-6513.2002.00148.x · Cited by 22
Drenth, B. B. V., Hulscher, M., van der Wouden, J. C., Mokkink, H. G. A., van Weel, C., & Grol, R. P. T. M. (1998) · Europe PMC (PubMed Central) · Cited by 22
Self-citationA matter of heart: the general practitioner consultation in an evidence-based world
Getz, L., Nilsson, P. M., & Hetlevik, I. (2003) · Scandinavian Journal of Primary Health Care · doi:10.1080/02813430310000483 · Cited by 19
Peters, T. J., Montgomery, A. A., & Fahey, T. P. (1999) · PubMed · Cited by 17
Beaulieu, M., Talbot, Y., Jadad, A. R., & Xhignesse, M. (2000) · Health Expectations · doi:10.1046/j.1369-6513.2000.00099.x · Cited by 11
Research works printed but not linked: 3
- Hulscher ME, 1997, Br J Gen Pract, 47, 711
- Yarnall K, 2003, Is there enough time for prevention. Am J Public Health, 93, 635
- Ely JW, 1998, Fam Med, 34, 34
Cited by
Sorted by citations
European Guidelines on cardiovascular disease prevention in clinical practice (version 2012)
Authors/Task Force Members:, Perk, J., De Backer, G., Gohlke, H., Graham, I., Reiner, Ž., Verschuren, M., Albus, C., Benlian, P., Boysen, G., et al. (2012) · European Heart Journal · doi:10.1093/eurheartj/ehs092 · Cited by 8,490
European guidelines on cardiovascular disease prevention in clinical practice: executive summary
Graham, I., Atar, D., Borch‐Johnsen, K., Boysen, G., Burell, G. K., Cífková, R., Dallongeville, J., Backer, G. D., Ebrahim, S. B. J., Gjelsvik, B., et al. (2007) · European Heart Journal · doi:10.1093/eurheartj/ehm316 · Cited by 3,865
Graham (2007) · doi:10.1097/01.hjr.0000277983.23934.c9 · Cited by 1,647
2016 European Guidelines on cardiovascular disease prevention in clinical practice
Authors/Task Force Members, Piepoli, M. F., Hoes, A. W., Agewall, S., Albus, C., Brotons, C., Catapano, A. L., Cooney, M. T., Corrà, U., Cosyns, B., et al. (2016) · European Journal of Preventive Cardiology · doi:10.1177/2047487316653709 · Cited by 1,435
A Predictive Model for Progression of Chronic Kidney Disease to Kidney Failure
Tangri, N. (2011) · JAMA · doi:10.1001/jama.2011.451 · Cited by 1,390
Metadata
- Authors
- Steenkiste, B. V., Weijden, T. V. D., Stoffers, H. E. J. H., & Grol, R.
- Affiliations
- Maastricht University (NL)
- Corresponding author
- Steenkiste, Ben van
- Venue
- Scandinavian Journal of Primary Health Care
- Publisher
- Informa UK Limited
- Published
- 2004-03
- Volume
- 22
- Issue
- 1
- Pages
- 32-37
- ISSN
- 0281-3432 (ISSN-L)
- 1502-7724
- OpenAlex
- W1995918858
- Cited by
- 104
- References
- 21
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 3 · 2020: 9 · 2018: 1 · 2017: 4 · 2016: 6 · 2015: 5 · 2014: 6 · 2013: 8 · 2012: 11
- FWCI
- 8.49
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Scandinavian Journal of Primary Health Care (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, other-oa)
- Radboud Repository (Radboud University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- guideline implementation, implementation barriers, general practitioners, cardiovascular risk communication, primary prevention, high-risk approach, occupational stress, patient demand, primary care
- MeSH terms
- Adolescent, Adult, Aged, Cardiovascular Diseases, Clinical Competence, Family Practice, Female, Humans, Interviews as Topic, Male, Middle Aged, Netherlands, Primary Health Care, Quality Assurance, Health Care, Risk Factors, Practice Guidelines as Topic, Risk Assessment, Guideline Adherence, Qualitative Research
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review