title: Selective prevention of cardiometabolic diseases in general practice: attitudes and working methods of male and female general practitioners before and after the introduction of the Prevention Consultation guideline in the Netherlands.
abstract: OBJECTIVE
  In 2011 the module cardiometabolic risk of the Prevention Consultation guideline was introduced in the Netherlands in order to prevent cardiometabolic diseases. We aimed to compare attitudes and working methods of Dutch general practitioners (GPs) towards selective prevention of cardiometabolic diseases before and after the introduction of the guideline and to study the effect of GP gender on these attitudes and working methods.
  
  
  METHODS
  We compared attitudes and working methods in prevention of cardiometabolic diseases in a cross-sectional survey among Dutch GPs in 2013 to the results of a comparable study performed in 2008.
  
  
  RESULTS
  Both in 2008 and 2013 30% responded. In 2013, more GPs reported to actively invite patients for preventive measurements. Thirty per cent of the GPs implemented the module cardiometabolic risk. In 2013, less GPs reported that it is worthwhile to make an effort to detect patients at increased risk for cardiometabolic diseases, and more GPs suggested that prevention may be performed by other stakeholders compared with 2008. Financial support and evidence for prevention programmes were mentioned as main facilitators for prevention. In 2013, more male than female GPs actively invite patients for preventive measurements.
  
  
  CONCLUSIONS
  More GPs report active preventive working methods after the introduction of the Prevention Consultation guideline, but only 30% implemented the guideline. More male than female GPs actively invite patients for preventive measurements. Compared with 2008 less GPs think it is worthwhile to make an effort to detect patients at increased risk and more GPs are willing to delegate preventive actions to other health institutions in 2013. As financial support and evidence for prevention are important facilitators for prevention, further research of the effectiveness of the guideline in preventing cardiometabolic diseases is necessary, and political choices have to be made in order to financially facilitate selective prevention in general practice.
authors.affiliation: Department of Primary and Community Care, Gender and Women's Health, Radboud UMC, Nijmegen, The Netherlands.
authors.forename: Hedwig M M
authors.initials: HM
authors.lastname: Vos
authors.forename: Diane H W J M
authors.initials: DH
authors.lastname: Van Delft
authors.forename: Miriam J J
authors.initials: MJ
authors.lastname: De Kleijn
authors.forename: Markus M J
authors.initials: MM
authors.lastname: Nielen
authors.forename: François G
authors.initials: FG
authors.lastname: Schellevis
authors.forename: Antoine L M
authors.initials: AL
authors.lastname: Lagro-Janssen
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005260:Female; D058006:General Practice; D058005:General Practitioners / Q000523:psychology; D006291:Health Policy; D006801:Humans; D008297:Male; D008659:Metabolic Diseases / Q000517:prevention & control*; D008875:Middle Aged; D009426:Netherlands; D016017:Odds Ratio; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation; D011795:Surveys and Questionnaires
keywords: cardiometabolic diseases; evidence-based prevention; gender; general practice; health policy; selective prevention