Barriers for general practitioners in post-stroke follow-up within a fragmented healthcare system in Sweden – a focus group study

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Publication Details

Journal
European Journal of General Practice
Published
2026-09-15
DOI
https://doi.org/10.1080/13814788.2026.2728342
Primary Topic
Acute Ischemic Stroke Management
Type
article
Field-Weighted Citation Impact
0.00
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article

Barriers for general practitioners in post-stroke follow-up within a fragmented healthcare system in Sweden – a focus group study

Mia von Euler, Axel C. Carlsson, Maria Flink, Jan Hasselström et al.
European Journal of General Practice
Acute Ischemic Stroke Management
article

Barriers for general practitioners in post-stroke follow-up within a fragmented healthcare system in Sweden – a focus group study

Mia von Euler, Axel C. Carlsson, Maria Flink, Jan Hasselström, Maria Wolf
article en

Abstract

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.

European Journal of General PracticeVol. 32(1)
Sophiahemmet University College (SE), Karolinska Institutet (SE), Primary Health Care (QA), Pro Persona (NL)
Openalex Percentile: Top 10%
Acute Ischemic Stroke Management
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