Implementing cardiometabolic health checks in general practice: a qualitative process evaluation

Area of Science:

• Primary Care
• Cardiometabolic Disease Screening
• Health Services Research

Background:

• Stepwise screening for cardiometabolic disease is recommended in primary care.
• Implementation of cardiometabolic health checks requires understanding caregiver and patient perspectives.

Purpose of the Study:

• To explore the implementation of a cardiometabolic health check.
• To understand the perceptions of caregivers and patients involved in the screening program.

Main Methods:

• Qualitative process evaluation using focus groups with caregivers and written questionnaires for patients.
• Thematic content analysis based on grounded theory principles was applied to the data.
• 1270 patients participated in the screening program; 657 provided questionnaire feedback.

Main Results:

• General practitioners (GPs) showed enthusiasm for systematic screening but lacked experience in program design and implementation.
• Patient participation was high, with most expressing enthusiasm for the health check.
• Suboptimal staff instruction, aggressive recruitment, and inadequate communication of outcomes and follow-up were identified.

Conclusions:

• Implementing systematic screening programs requires careful preparation of staff and integration into clinical practice.
• Addressing the approach to healthy patients and establishing adequate follow-up programs are crucial for successful screening.
• A checklist was developed to guide future cardiometabolic screening program design based on identified challenges.