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Table 1 Barriers to carrying out cardiovascular risk assessment, and possible interventions to address these

From: Improving prescribing of antihypertensive and cholesterol-lowering drugs: a method for identifying and addressing barriers to change

Possible barriers Possible interventions
Time-consuming procedure for the physician - Easy-to-use tools (e.g. risk calculator for computer) - The patients or an assistant could carry out the risk assessment - Offer economic compensation
Physician has no risk assessment tool at hand - Provide risk assessment tool
The patients are focused on single risk-factors, not the global picture - Patient-information
Physicians are not used to risk estimation, not educated to do this - Educational outreach visit - Training
Lack of knowledge among physicians of the relevance of global risk assessment - Information/education (outreach visit)
Physicians have more trust in their own clinical judgement than tables or charts - Education (e.g. case discussions during outreach visit)
Differences in opinion among physicians on the importance of treatment of hypertension and hypercholesterolaemia - Use opinion-leaders and convince clinicians of the high degree of consensus in clinical guidelines
May be uncomfortable for physicians to discuss risk-factors with patients - Patient-information - Offer strategies on how to communicate such information with patients