Introduction: Interprofessional collaboration (IPC) is becoming more widespread in primary care due to the increasing complex needs of patients. However, its implementation can be challenging. We aimed to identify barriers and facilitators of IPC in primary care settings.Methods: An overview of reviews was carried out. Nine databases were searched, and two independent reviewers took part in review selection, data extraction and quality assessment. A thematic synthesis was carried out to highlight the main barriers and facilitators, according to the type of IPC and their level of intervention (system, organizational, inter-individual and individual).Results: Twenty-nine reviews were included, classified according to six types of IPC: IPC in primary care (large scope) (n = 11), primary care physician (PCP)-nurse in primary care (n = 2), PCP-specialty care provider (n = 3), PCP-pharmacist (n = 2), PCP-mental health care provider (n = 6), and intersectoral collaboration (n = 5). Most barriers and facilitators were reported at the organizational and inter-individual levels. Main barriers referred to lack of time and training, lack of clear roles, fears relating to professional identity and poor communication. Principal facilitators included tools to improve communication, co-location and recognition of other professionals' skills and contribution. Conclusions:The range of barriers and facilitators highlighted in this overview goes beyond specific local contexts and can prove useful for the development of tools or guidelines for successful implementation of IPC in primary care.

BackgroundAccording to the Organization for Economic Cooperation and Development, the Swiss healthcare system is one of the most effective in the world. Yet, as other occidental countries, it has to face the increase of chronic diseases frequency and its resulting cost, particularly for primary care (PC). However very few consistent data are available to describe PC features and its evolution over time. The aim of this study is to describe the evolution of the Swiss PC physicians’ (PCPs) profile and activities between 1993 and 2012.MethodsThe date come from two independent European surveys carried out in Switzerland respectively in 1993 and 2012. Both surveys were cross-sectional ones and based on representative samples of 200 PCPs, interviewed by questionnaire.ResultsIn 20 years, PCPs became older (median age 46 vs 56, p < 0.001) and more feminized (7 % vs 22 %, p < 0.001). Nowadays, they more often work in group practices (28 % vs 52 % in 2012, p < 0.001) and are more involved in other paid activities (28 % vs 66 % in 2012, p < 0.001). All the PCPs have a computer in 2012 (78 % in 1993, p < 0.001) and it is mostly used for keeping records of consultations (47 %). The number of daily face-to-face contacts with patients decreased from 31 to 24 but the average length rose from 15 to 20 min (p < 0.001). PCPs provide fewer pediatric and gynecological services but their activity remains globally unchanged in other domains. The frequency of meetings with other disciplines decreased significantly (e.g. once/month face-to-face meets with ambulatory specialists: 78 % vs 23 % in 2012, p < 0.001). The involvement of PCPs in follow-up and treatment of chronic disease globally little differed. In 2012, 8.5 % of the PCPs never performed any chirurgical acts (vs 0 % in 1993, p < 0.001).ConclusionThis study showed a substantial evolution of Swiss PC over the last twenty years in terms of socio-demographic, organizational and service provided. The main changes include: feminization and ageing, lower diversity in services provided, fewer but longer consultations. These changes may have important implications for patients’ management and will need to be considered for health planning purposes.

These results should be taken into account to adapt strategies of mental health disorders prevention at work, for a better efficacy.

BackgroundRepresenting 60% of medical consultations in Switzerland, primary care holds an important place in our medical system. Patients’ values in family medicine (FM) are nowadays recognized as important factors to take into account in order to provide good quality of care. The aim of this study is to describe patients’ most important values regarding FM and to assess their associations with socio-demographics factors in a fee-for-services health system.MethodsWe analyzed the Swiss 2012 study on Quality and Costs of Primary Care (QUALICOPC). Two-hundred patients, randomly drawn, answered a questionnaire about their values regarding FM just after their consultation. Explored values were related to communication and patient-centeredness care, continuity and coordination, care access, and patients’ activation. We described values reaching more than 50% of “very important”. Then, multivariate analyses were performed for the most important value of each dimension.ResultsItems related to “communication and patient-centeredness care” and “coordination and continuity of care” are the most recurrently mentioned as “very important”. Items related to access and patients’ activation are generally declared as “very important” by less than 50% of patients. Whatever the domain and the item, women systematically grant items more often as “very important” than men. Variations are observed according to the age, and the presence or not of a chronic disease.ConclusionSuch dimensions should be subject to a special attention by general practitioners and public health authorities as it might enhance the quality of care and the patients’ satisfaction.