NPT-dimensions | Enablers | Barriers |
---|---|---|
Coherence | Training [9] Physician champion [35] Clarification of roles and responsibilities among professionals [40, 42, 29] | Lack of educational programs [31] |
Cognitive participation | Professionals made aware of positive patient outcomes [41, 32, 38] Local opinion leaders [32, 35, 40] Covering PCPs operating costs related to collaborative care [40] Psychiatric supervision can ease scepticism among staff about medication [39] | Lack of engagement among the PCPs [33, 9, 32, 34, 37, 31] Time pressures [33, 9, 43, 38, 30] Problems with reimbursement [38] PCPs being uncomfortable with diagnosing and treating mental health illness [32, 34, 39] PCP concerns about sharing patients’ private health information [35] |
Collective action | Co-location of CM and PCP [9, 32, 37, 29, 39, 38, 40, 6] Regular face-to-face interaction between professionals [9, 32, 38, 29] Interaction between professionals being centered on patient cases [33] Face-to-face patient referral between professionals [40] Professionals able to engage with patients [36, 42, 39, 29] CMs’ social and professional skills, e.g. being visible, able to build relationships [33, 32, 34, 29, 40] Good educational programs for CMs [33, 34, 29, 40] Model not being burdensome or create a problems with workload [32, 41, 43] Instruments for including patients and keeping track of progress [34, 29, 35, 30] | Absence of co-location of CM and PCP [33, 9, 32, 34] Lack of space for additional staff [39, 32] Difficulties engaging patients due to patients’ problems being too severe or complex [9, 36] and/or due to patients’ preferences [6] Primary care staff having difficulties managing mental health problems [34] Making the model work experienced as consuming [39, 9, 30, 38] IT-systems hindered effective communication (e.g. double registration, limited access, lack of integration) [9, 37, 29, 39, 34]. |
Reflexive monitoring | Professionals experience that patients benefit from collaborate care [32, 35, 38] Primary care providers value systematic patient feedback [33, 32, 29, 38] and instruments for monitoring patient progress [34, 36, 35, 30] Systematic monitoring enable active follow up which strengthen implementation [29] | Lack of systems for monitoring patient progress [33] Absence of immediate access to objective data on patient progress [39] |