{"id":"55305eb950ef","type":"article","url":"https://hartvaat.nl/2026/12/01/barrieres-in-de-post-stroke-nazorg-door-huisartsen-in-een-gefragmenteerd-zorgsys/","title":"Barrières in de post-stroke nazorg door huisartsen in een gefragmenteerd zorgsysteem","title_en":"Barriers for general practitioners in post-stroke follow-up within a fragmented healthcare system in Sweden - a focus group study.","category":"preventie","category_label":"Preventie","professions":["huisarts"],"tags":[],"journal":"The European journal of general practice","doi":"10.1080/13814788.2026.2728342","source_url":"https://doi.org/10.1080/13814788.2026.2728342","authors":["Maria Wolf","Maria Flink","Axel C Carlsson","Mia von Euler","Jan Hasselström"],"significance":3,"published":"2026-09-22","source_date":"2026-12-01","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/lipidenverlaging-stappenplan/","https://hartvaat.nl/kennis/preventie/aspirine-primaire-preventie/"],"congress":"","summary_en":"A qualitative focus group study of 49 Swedish GPs highlights structural barriers to post-stroke follow-up, including time constraints, unclear medication renewal responsibilities, and inadequate hospital-to-primary care referrals. Participants emphasized challenges in managing medication adherence and called for more GPs, targeted education, and standardized follow-up protocols. The findings underscore the need for systemic improvements to strengthen secondary stroke prevention in primary care.","created":"2026-09-16T00:53:23Z","updated":"2026-09-16T00:53:23Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een kwalitatieve focusgroepstudie onder 49 huisartsen in Zweden toont aan dat structurele knelpunten, zoals tijdsgebrek, onduidelijke verantwoordelijkheden voor medicatiewijzigingen en een gebrek aan goede doorverwijzingen vanuit het ziekenhuis, de nazorg na een beroerte bemoeilijken. De huisartsen benadrukken de complexiteit van medicatie-adherentie en pleiten voor meer huisartsen, betere scholing en gestructureerde nazorgprotocollen. Deze inzichten onderstrepen de behoefte aan systeemverbeteringen om de kwaliteit van secundaire preventie in de eerste lijn te waarborgen.","abstract_original":"BACKGROUND: Secondary medical prevention after stroke is effective and well evidenced, making long-term follow-up crucial. This follow-up is mainly made by general practitioners (GPs) in Sweden. Low target achievement and up to fourfold practice variation in dispensation of secondary preventive drugs between different primary care units in Region Stockholm has been described. Although several factors in individual practices have been observed to be associated with insufficient target achievements, the underlying reasons for this variation are unclear. OBJECTIVES: To explore the perspectives of GPs concerning secondary preventive practices after stroke to shed light on areas of improvement. METHODS: This qualitative study was based on eight focus group discussions with 49 GPs in Region Stockholm. They were strategically invited in relation to target achievement, and the interviews (45-55 min) were conducted using a semi-structured interview guide. The interviews were transcribed and analysed using qualitative content analysis. RESULTS: There were two themes: \"Multifaceted mission in an insufficiently organized healthcare system\" and \"The complexity of adherence\". There were six categories that encompassed shortcomings in the areas of: sufficient time for the patients, the overarching structure of the healthcare system, the internal structure of follow-ups, medical adherence, the responsibility for renewals of medication and tools for adherence. CONCLUSION: The perspectives of GPs revealed structural problems at different levels in the health care system as well as difficulties in handling medication adherence indicating a need for improvement. GPs touched on solutions including increasing the number of GPs, education and improved referrals from hospital to primary care."}