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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. |
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| Stake- holder |
Facilitators |
Barriers |
Project strategies |
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| 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 |
| Limitations of conventional care in certain areas/cases |
Primary care unit resources |
General practitioner meetings with management/administration about resource allocation and logistics |
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| Personal interest to provide more holistic primary care |
No formal IM recognition in Sweden |
Priority of reimbursing CT providers |
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| Improve knowledge and evidence base of IM |
Scientific evidence base |
Part-time provider commitment |
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| Improve recognition of IM |
Large variation of CT terminologies and documentation routines |
Ethical clearance |
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| The Swedish Health Services Act |
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| 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 |
| CT access to interdisciplinary cooperation |
No official recognition of CT professions |
An IM model broad enough to encompass all selected CTs/medical models |
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| Represent different medical models within Swedish primary care |
Interdisciplinary dialogue rare |
Consensus case conferences to facilitate and document interdisciplinary dialogue |
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| Extend the evidence-based medicine concept |
Unfamiliarity with primary care documentation routines |
Part time CT provider commitment |
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| Improve national awareness and recognition of existing international IM practices |
The Swedish Health Services Act |
Include quality of life, stress and wellbeing outcomes |
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| Improve focus on care, health promotion and Prevention |
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| RES |
Explore stakeholder perspectives on IM in Swedish primary care |
Limited evidence base for IM |
Initial core group development meetings to facilitate research project |
| 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 |
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| 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 |
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| 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 |
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| No pre-defined or given set of outcomes |
Referral network of primary care units |
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| No established referral network |
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Sundberg et al. BMC Health Services Research 2007 7:107 doi:10.1186/1472-6963-7-107 |
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