Factors for the integration of prevention in primary care: an overview of reviews

Abstract

Background: The global burden of non-communicable diseases is increasing and the need for prevention is huge. Policies have yet to produce results and prevention indicators remain low. Primary care (PC) represents an opportunity to optimise the practice of prevention, but GPs are coming up against barriers that are holding back their prevention practices. Aim: To identify the barriers and facilitators for the implementation of routine prevention practices in PC. Design & setting: This study is an international overview of reviews focusing on the integration of prevention in PC settings. Method: The search was conducted in July 2022 using MEDLINE, Embase, Web of Science, and the Cochrane Database of Systematic Reviews. Included reviews are systematic reviews or scoping reviews adopting a systematic approach. Results: The 35 reviews included identify multiple barriers and facilitators related to the integration of prevention in PC. These factors are heterogeneous with regard to their source (the patient, the professional, and the health system) and their level of action (individual, organisational, or contextual). The results show the need to organise PC at the professional level (for example, in training), at the local level (for example, the information system), and at the political level (for example, the unclear definition of the role of professionals). Conclusion: The factors influencing the integration of prevention in PC are multiple and act at different levels (individual, organisational, and health-system level). Organisation factors play a major role and seem to be a means of overcoming the difficulties encountered by healthcare professionals in developing preventive practices.

Keywords

• prevention
• preventive health services
• primary health care
• service organisation
• general practice