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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