Table 1 Stakeholder perspectives. Summary of conventional care (CC), complementary therapies (CT) and research (RES) stakeholder perspectives on facilitators, barriers and strategies for developing and implementing a model of integrative medicine (IM) in Swedish primary care.
From: Towards a model for integrative medicine in Swedish primary care
Stake- holder | Facilitators | Barriers | Project strategies |
|---|---|---|---|
CC | Documented public desire for increased collaboration | Lack of knowledge and know-how | General practitioner gatekeeper with CT interest, knowledge and experience leading the clinical part |
| Â | Limitations of conventional care in certain areas/cases | Primary care unit resources | General practitioner meetings with management/administration about resource allocation and logistics |
| Â | Personal interest to provide more holistic primary care | No formal IM recognition in Sweden | Priority of reimbursing CT providers |
| Â | Improve knowledge and evidence base of IM | Scientific evidence base | Part-time provider commitment |
| Â | Improve recognition of IM | Large variation of CT terminologies and documentation routines | Ethical clearance |
| Â | Â | The Swedish Health Services Act | Â |
CT | Increase respect for patients' treatment choices | Value added tax (25%) on CTs and no public insurance policy for CTs | CT providers with experience sharing cases with conventional providers |
| Â | CT access to interdisciplinary cooperation | No official recognition of CT professions | An IM model broad enough to encompass all selected CTs/medical models |
| Â | Represent different medical models within Swedish primary care | Interdisciplinary dialogue rare | Consensus case conferences to facilitate and document interdisciplinary dialogue |
| Â | Extend the evidence-based medicine concept | Unfamiliarity with primary care documentation routines | Part time CT provider commitment |
| Â | Improve national awareness and recognition of existing international IM practices | The Swedish Health Services Act | Include quality of life, stress and wellbeing outcomes |
| Â | Improve focus on care, health promotion and Prevention | Â | Â |
RES | Explore stakeholder perspectives on IM in Swedish primary care | Limited evidence base for IM | Initial core group development meetings to facilitate research project |
| Â | Explore patient experiences of integration of complementary therapies in primary care | Lack of published randomised clinical trials of IM in primary care | Include both qualitative and quantitative methods of evaluation |
| Â | Explore general clinical effectiveness of the IM model vs. treatment as usual | Difficulties to obtain research funding | Information and educational seminars to improve understanding between stakeholders and facilitate shared documentation routines |
| Â | Improve the evidence base for integration of CTs into primary care | Unknown recruitment speed and recruitment pattern of patients | Continuous grant writing to secure funding |
| Â | Â | No pre-defined or given set of outcomes | Referral network of primary care units |
| Â | Â | No established referral network | Â |