Barriers and facilitators among health professionals in primary care to prevention of cardiometabolic diseases: a systematic review
Open accessAbstract
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.
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Diabetes is a well-established risk factor for ischaemic heart disease, and CAD accounts for 40-80% of deaths in patients with T2DM.
“Diabetes is a well-established risk factor for ischaemic heart disease (IHD), and CAD accounts for 40-80% of deaths in patients with T2DM.148,359,381”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [381]
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Research works printed but not linked: 1
- Huy C, Diehm C, Schneider S. Cardiovascular prevention at the general practitioner? First results of a study on attitudes, services, success and bar- riers in practice. Dtsch Med Wochenschr 2012; 137: 17-22.
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2021 ESC Guidelines on cardiovascular disease prevention in clinical practice
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- Authors
- Wändell, P. E., de Waard, A.-K. M., Holzmann, M. J., Gornitzki, C., Lionis, C., de Wit, N., Søndergaard, J., Sønderlund, A. L., Kral, N., Seifert, B., Korevaar, J. C., Schellevis, F. G., & Carlsson, A. C.
- Affiliations
- Karolinska Institutet (SE)
- Julius Center for Health Sciences and Primary Care, University medical Center, Utrecht, The Netherlands
- Karolinska University Hospital (SE)
- University of Crete (GR)
- University of Southern Denmark (DK)
- Department of General Practice, Charles University, First Faculty of Medicine, Prague, Czech Republic
- Charles University (CZ)
- Netherlands Institute for Health Services Research (NL)
- Uppsala University (SE)
- Corresponding author
- Carlsson, Axel C
- ORCID
- Venue
- Family Practice
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-01-29
- Volume
- 35
- Issue
- 4
- Pages
- 383-398
- ISSN
- 0263-2136 (ISSN-L)
- 1460-2229
- OpenAlex
- W2793231057
- Cited by
- 120
- References
- 68
- Citations by year
- 2026: 12 · 2025: 14 · 2024: 19 · 2023: 16 · 2022: 15 · 2021: 23 · 2020: 13 · 2019: 7 · 2018: 1
- FWCI
- 2.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Family Practice (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Utrecht University Repository (Utrecht University) (submittedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- European Union’s Health Programme
- Topics
- 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
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Keywords
- cardiometabolic disease prevention, barriers and facilitators, clinician attitudes, patient counseling, time constraints, reimbursement, referral, GP-patient relationship, patient adherence, professional training
- MeSH terms
- Attitude of Health Personnel, Cardiovascular Diseases, Health Personnel, Humans, Metabolic Diseases, Preventive Health Services, Primary Health Care, Qualitative Research
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