SPIMEU Determinants of successful Implementation of Selective Prevention of cardio-metabolic diseases across Europe SPIMEU

Barriers and facilitators among healthcare providers and patients for selective prevention of cardiometabolic diseases Joke Korevaar on behalf of Wändell PE, de Waard AKM , Holzmann MJ, Gornitzki C, Lionis C, de Wit NJ, Søndergaard J, Sønderlund A, Schellevis FG, Hollander M, and Carlsson AC SPIMEU

? First question  mobile phone/tablet/laptop Selective cardio-metabolic prevention should preferably be coordinated by primary care. SPIMEU

Aim Systematic review on hampering and facilitating factors for selective prevention of CMD among health care professionals Key-articles – backward-forward citation key-articles – search terms from key-articles Medline – Embase - Cinahl SPIMEU

Results of the search 10,566 hits – 6,683 unique hits Screening Title + abstract Scoring full-text  28 articles SPIMEU

Results – 28 articles Barriers and facilitators on the level of: structure, organisation, and professional and social context. Structure – barriers: Lack of support, lack of IT, no focus on prevention Structure – facilitators: strong support, good IT-support, strong focus on SPIMEU

Results – 28 articles Organisation Barriers: Lack of time, lack of reimbursement Facilitators: part of daily routine, reimbursement SPIMEU

Results – 28 articles Professional context Barriers: Lack of training/experience/knowledge Facilitators: sufficient training/knowledge, confidence Social context B: lack of pt adherence / family support F: long relation with pt / enlisting help family SPIMEU

Results – 28 articles Attitude B: Doubts about benefit / usefulness, lack of motivation, causes problems for the patient F: feel responsible to offer prevention, importance of prevention SPIMEU

Conclusion Same barriers/facilitators observed in different countries, even if the setting or primary health care system differed. Two studies from the same country can observe opposite barriers/facilitators Barrier can be, in a different setting, a facilitator SPIMEU

? Selective cardio-metabolic prevention programs should firstly be implemented as a pilot in each respective country and then tailored to the specific contexts that apply to that country SPIMEU