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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.