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Table 3 Summary of mentioned determinants by healthcare professionals and patients

From: Perceived determinants of cardiovascular risk management in primary care: disconnections between patient behaviours, practice organisation and healthcare system

  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