title: Barriers to implementing cardiovascular risk tables in routine general practice.
abstract: 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.
authors.affiliation: 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
authors.forename: Ben
authors.initials: B
authors.lastname: van Steenkiste
authors.forename: Trudy
authors.initials: T
authors.lastname: van der Weijden
authors.forename: Henri E J H
authors.initials: HE
authors.lastname: Stoffers
authors.forename: Richard
authors.initials: R
authors.lastname: Grol
mesh_terms: 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