Table 3 Summary of mentioned determinants by healthcare professionals and patients
| Â | Determinants mentioned by healthcare professionals | Determinants mentioned by patients with established CVD or at high cardiovascular risk |
|---|---|---|
1. Guideline factors | • Practice guideline CVRM • ‘Care Standard’ | • Practice guideline CVRM • ‘Care Standard’ |
2. Individual healthcare professional factors | • Positive about practice nurses • GPs are role models, too busy and clinical inert • Motivational interviewing | • Positive about practice nurses • GPs listen carefully, motivates patients but not always available • Positive about the care and measurements |
3. Patient factors | • Not enough knowledge about CVRM • Motivated to improve their health • Not positive about patients self- management • Money can be an obstacle | • Knowledge of a healthy lifestyle • Take good care of themselves • Medication adherence important but difficult due to side effects |
4. Professional interaction | • Communication can be improved between GPs and specialists • Collaboration healthcare professionals in general practice is good • Paramedics are important | • Communication between GPs and specialists is rather varied • Collaboration between healthcare professionals in the general practice is good |
5. Incentives and recourses | • Time as biggest barrier • Due to ‘open market operation’ more critical look is needed • Digital patient files are helpful but not always accessible | • GP has insufficient time • Information provision is satisfactory • Internet is consulted by half of the patients • Digital patient files are favored |
6. Mandate, authority and accountability | • Cannot make health effects provable |  |
7. Social, political and legal factors | • Dutch government not rated positive • Health insurers should not determine medical policy • GPs responsible for a lot of patients | • The Ministry of Health is much interested in cash excises • Healthcare too expensive • Reimbursements by health insurers • Reforming healthcare |