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Cardiovascular risk management in patients using antipsychotics: a qualitative feasibility study
Karlijn Joëlle van den Brule-Barnhoorn1, Kirstine Marieke Jakobs2,3, Jan van Lieshout4
1Department of Primary and Community Care, Radboudumc, Nijmegen, Netherlands karlijn.vandenbrule-barnhoorn@radboudumc.nl.
BJGP Open
|August 8, 2025
Summary
Implementing the TACTIC cardiovascular risk program for antipsychotic patients requires adjustments. A feasibility study identified patient tension and GP workload as barriers, but a person-centered approach was a facilitator, guiding future randomized controlled trials.
Area of Science:
- Cardiology
- Psychiatry
- General Practice
Background:
- Patients on antipsychotic medication face elevated cardiovascular disease (CVD) risk.
- General practice lacks robust CVD risk management strategies for this population.
- The TACTIC program piloted a multidisciplinary approach to reduce CVD risk and review antipsychotic use.
Purpose of the Study:
- To identify barriers and facilitators for implementing the TACTIC intervention.
- To determine necessary adjustments for future randomized controlled trials (RCTs).
- To assess the intervention's effectiveness and implementability.
Main Methods:
- Qualitative feasibility study conducted in three Dutch general practices.
- Semi-structured interviews with 8 patients and 2 focus groups with 11 healthcare professionals.
- Analysis guided by Normalization Process Theory using the Framework Method.
Main Results:
- Barriers included patient tension, multidisciplinary meeting dynamics, and GP workload.
- Facilitators involved the person-centered approach, clear information, and adaptable roles.
- Suggestions included psychiatrist summary reports, improved patient expectation management, and refined target group definition.
Conclusions:
- Adjustments to the TACTIC intervention are essential before a large-scale RCT.
- Feasibility studies are crucial for enhancing trial effectiveness and efficacy.
- This study highlights the need for tailored risk management in patients on antipsychotics.
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