ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2015
GPs' perspectives on secondary cardiovascular prevention in older age: a focus group study in the Netherlands.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Barriers for general practitioners in post-stroke follow-up within a fragmented healthcare system in Sweden - a focus group study.The European journal of general practice · 2026Article
- Long-term risk-factor control and secondary prevention are insufficient after first TIA: Results from QregPV.European stroke journal · 2024Article
- Assessment of the appropriateness of cardiovascular preventive medication in older people: using the RAND/UCLA Appropriateness Method.BMC geriatrics · 2022Article
- Prescribing and medical non-adherence after myocardial infarction: qualitative interviews with general practitioners in Germany.BMC family practice · 2020Article
- Article
- General practitioners' reasoning on risk screening and primary prevention of stroke - a focus group study.BMC family practice · 2018Article
- Deprescribing preventive medication in older patients.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Article
- Management of patients with persistent medically unexplained symptoms: a descriptive study.BMC family practice · 2018Observational
- Prescribing and deprescribing antihypertensive medication in older people by Dutch general practitioners: a qualitative study.BMJ open · 2018Article
- Burden of cardiovascular disease across 29 countries and GPs' decision to treat hypertension in oldest-old.Scandinavian journal of primary health care · 2018Article
- Suboptimal primary and secondary cardiovascular disease prevention in HIV-positive individuals on antiretroviral therapy.European journal of preventive cardiology · 2017Article
- Variation in GP decisions on antihypertensive treatment in oldest-old and frail individuals across 29 countries.BMC geriatrics · 2017Article
- Use of theory to plan or evaluate guideline implementation among physicians: a scoping review.Implementation science : IS · 2017Article
- General Practitioners' Decision Making about Primary Prevention of Cardiovascular Disease in Older Adults: A Qualitative Study.PloS one · 2017Article
- Drug prescription rates in secondary cardiovascular prevention in old age: Do vulnerability and severity of the history of cardiovascular disease matter?Scandinavian journal of primary health care · 2015Observational
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Authors and funding
4 authors.
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Abstract
backgroundAlthough guidelines recommend secondary cardiovascular prevention irrespective of age, in older age the uptake of treatment is lower than in younger age groups.
aimTo explore the dilemmas GPs in the Netherlands encounter when implementing guidelines for secondary cardiovascular prevention in older age. DESIGN AND
settingQualitative study in four focus groups consisting of GPs (n = 23, from the northern part of the province South Holland) and a fifth focus group consisting of GP trainees (n = 4, from the Leiden University Medical Center).
methodFocus group discussions were organised to elicit perspectives on the implementation of secondary cardiovascular prevention for older people. The 14 theoretical domains of the refined Theoretical Domains Framework (TDF) were used for (deductive) coding of the focus group discussions. The coded texts were analysed, content was discussed, and barriers and facilitators were identified for each domain of the TDF.
resultsThe main theme that emerged was 'uncertainty'. Identified barriers were guideline-related, patient-related, and organisation-related. Identified facilitators were doctor-related, patient-related, and organisation-related. The main aim of secondary preventive treatment was improvement in quality of life.
conclusionGPs in the Netherlands are uncertain about many aspects of secondary cardiovascular prevention in older age; the guidelines themselves, their own role, patient factors, and the organisation of care. In view of this uncertainty, GPs consciously weigh all aspects of the situation in close dialogue with the individual patient, with the ultimate aim of improving quality of life. This highly-individualised care may largely explain the reduced prescription rates.
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