Barriers and facilitators for the uptake of the national INOCA recommendation among Dutch cardiologists: A survey study.
- 1Department of Primary and Community Care, Radboud Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, the Netherlands.
- 2AG 10 Sex- and Gender-Sensitive Medicine, Medical Faculty OWL, University of Bielefeld, Bielefeld, Germany.
Abstract
Background
In 2020, the Dutch Society for Cardiologists (NVVC) published a national recommendation for diagnostics and treatment of Ischaemia with Non-Obstructive Coronary Arteries (INOCA), a historically underrecognized condition. In this study we identify determinants of implementation of the NVVC INOCA recommendation through a national survey among Dutch cardiologists.Methods
We performed a cross-sectional, nationwide online survey among Dutch cardiologists, incorporating attitudinal statements derived from prior qualitative research and the Measurement Instrument for Determinants of Innovation (MIDI) questionnaire. Descriptive analyses were used to identify facilitators and barriers to implementation. Multiple regression analyses examined associations between attitudinal factors and familiarity with the recommendation.Results
A total of 134 cardiologists participated in this study with 78 (58%) completing the long version of the questionnaire and 56 (42%) the short version. Facilitators for implementation were predominantly user-related, driven by positive outcome expectations, perceptions of professional responsibility, and perceived communicative capabilities. In contrast, key barriers were primarily organizational, including the absence of institutional policies, implementation coordination, and performance feedback. Familiarity with the recommendation was independently associated with perceived improvements in INOCA-related knowledge, confidence in communicating under clinical uncertainty, and gender.Conclusions
Uptake of the NVVC INOCA recommendation among Dutch cardiologists is largely motivated by individual professional commitment and positive outcome expectations but is constrained by limited organizational support. Strengthening institutional implementation structures and reinforcing professional communicative capabilities may help translate high individual motivation into consistent peer-dissemination and recommendation-concordant INOCA care.
Related
- Uptake, Barriers, and Facilitators of Open Science in Clinical Psychology: Findings from an Exploratory Survey in German-speaking Countries
- Facilitators and barriers to nurses’ adherence to traumatic brain injury management guidelines at the accident and emergency unit in a national referral hospital in Uganda: a qualitative study
- Barriers and facilitators to implementing national sodium reduction programs in rural China: a qualitative study
- Not Sick, Yet Treated: Barriers and Facilitators to Tuberculosis Preventive Treatment Uptake Among Household Contacts of Tuberculosis Patients in Moulvibazar District, Bangladesh
- Predoctoral grant writing among physician-scientist trainees: a national survey of barriers and facilitators of success
BibTeX
@article{gottgens2026barriers,
title = {{Barriers and facilitators for the uptake of the national INOCA recommendation among Dutch cardiologists: A survey study.}},
author = {Irene Göttgens and Lianne C G Roelofs and Jojanneke Smeenk and Linda Modderkolk and Sabine Oertelt-Prigione},
journal = {International journal of cardiology. Cardiovascular risk and prevention},
year = {2026},
month = oct,
doi = {10.1016/j.ijcrp.2026.200718},
url = {https://europepmc.org/article/MED/42903840},
note = {CC BY},
}
RIS
TY - JOUR
TI - Barriers and facilitators for the uptake of the national INOCA recommendation among Dutch cardiologists: A survey study.
AU - Irene Göttgens
AU - Lianne C G Roelofs
AU - Jojanneke Smeenk
AU - Linda Modderkolk
AU - Sabine Oertelt-Prigione
PY - 2026
DA - 2026/10/08
JO - International journal of cardiology. Cardiovascular risk and prevention
DO - 10.1016/j.ijcrp.2026.200718
UR - https://europepmc.org/article/MED/42903840
AB - Background In 2020, the Dutch Society for Cardiologists (NVVC) published a national recommendation for diagnostics and treatment of Ischaemia with Non-Obstructive Coronary Arteries (INOCA), a historically underrecognized condition. In this study we identify determinants of implementation of the NVVC INOCA recommendation through a national survey among Dutch cardiologists.Methods We performed a cross-sectional, nationwide online survey among Dutch cardiologists, incorporating attitudinal statements derived from prior qualitative research and the Measurement Instrument for Determinants of Innovation (MIDI) questionnaire. Descriptive analyses were used to identify facilitators and barriers to implementation. Multiple regression analyses examined associations between attitudinal factors and familiarity with the recommendation.Results A total of 134 cardiologists participated in this study with 78 (58%) completing the long version of the questionnaire and 56 (42%) the short version. Facilitators for implementation were predominantly user-related, driven by positive outcome expectations, perceptions of professional responsibility, and perceived communicative capabilities. In contrast, key barriers were primarily organizational, including the absence of institutional policies, implementation coordination, and performance feedback. Familiarity with the recommendation was independently associated with perceived improvements in INOCA-related knowledge, confidence in communicating under clinical uncertainty, and gender.Conclusions Uptake of the NVVC INOCA recommendation among Dutch cardiologists is largely motivated by individual professional commitment and positive outcome expectations but is constrained by limited organizational support. Strengthening institutional implementation structures and reinforcing professional communicative capabilities may help translate high individual motivation into consistent peer-dissemination and recommendation-concordant INOCA care.
SN - 2772-4875
ER -