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Table 3 Leverage points and key initiatives identified by stakeholders

From: Patient’s access to healthcare and treatment in rheumatoid arthritis: the views of stakeholders in Portugal

Leverage points

Group of stakeholders

Key initiative

Attractiveness for stakeholders*

Potential impact

Required investment

Required effort

   

Global appreciation

Improve epidemiological and clinical knowledge of RA

U-GP, R-GP, REU, ANDAR

Optimization of RA National Registry

Clearly interesting

Medium

Medium

Medium

Promote patient’s knowledge about RA

U-GP, R-GP, REU, ANDAR

Dissemination of information on rheumatic symptoms in primary care centres

Clearly interesting

Medium

Low

Low

U-GP, R-GP, REU, ANDAR

Valorisation of RA and adequate treatment

Likely interesting

Medium

Low

Low

Promote GPs’ knowledge about RA

U-GP, R-GP, REU

Regular visits of specialists to primary healthcare centres

Clearly interesting

Medium

Low

Medium

U-GP, R-GP, REU, PHA

Regular training sessions about RA for GPs

Clearly interesting

Medium

Low

Low

Promote fulfilment of biologics guidelines

REU, SPR

Promote successful case reports about biologic treatment

Likely interesting

Medium

Low

Low

REU, SPR

Promote broader utilization of diagnosis and monitoring tools

Likely interesting

Medium

Low

High

HMA, REU

Implement hospital-based research to collect real-world data

Clearly interesting

Medium

Medium

Medium

  1. Although barriers were identified, no leverage points resulted from the interviews with the budget holders.
  2. *graded as: not interesting, likely interesting, clearly interesting. graded as: low, medium, high.
  3. U-GP: urban general practitioner, R-GP: rural general practitioner, REU: rheumatologist, ANDAR: Rheumatoid Arthritis Patient Association, PHA: pharmaceutical managers and purchasers; SPR: Portuguese Society of Rheumatology, HMA: hospital managers.