Barriers to implementing cardiovascular risk tables in routine general practice.
METHODS
Qualitative study. GPs were interviewed after analysing two audiotaped cardiovascular consultations.


METHODS
Primary health care.


METHODS
A sample of 15 GPs who audiotaped 22 consultations.


METHODS
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.


CONCLUSIONS
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.
van Steenkiste
Ben
B
Center for Quality of Care Research, Department of General Practice/Care and Primary Health Research Institute, Maastricht University, Maastricht, The Netherlands. Ben.vanSteenkiste@hag.unimaas.nl
van der Weijden
Trudy
T
Stoffers
Henri E J H
HE
Grol
Richard
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D002983:Clinical Competence; D005194:Family Practice / Q000592:standards*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000592:standards*; D036301:Qualitative Research; D011785:Quality Assurance, Health Care; D018570:Risk Assessment / Q000706:statistics & numerical data*; D012307:Risk Factors