Health care professionals’ perceptions about atrial fibrillation care in the Brazilian public primary care system: a mixed-methods study

BMC Cardiovascular Disorders

Research Article

Elisabete Paschoal¹  Alessandra C. Goulart¹  Rodrigo D. Olmos²  Paulo A. Lotufo²  Isabela M. Benseñor²  Kate Jolly³  Emma Lancashire³  Tiffany E. Gooden³  Semira Manaseki-Holland³  G. Neil Thomas³  Sheila Greenfield³  Deirdre A. Lane⁴  Gregory Y. H. Lip⁵ 

[1] Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de Sao Paulo, Sao Paulo, Brazil;Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de Sao Paulo, Sao Paulo, Brazil;School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil;Institute for Applied Health Research, University of Birmingham, Birmingham, UK;Institute for Applied Health Research, University of Birmingham, Birmingham, UK;Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK;Institute for Applied Health Research, University of Birmingham, Birmingham, UK;Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK;Department of Clinical Medicine, Aalborg University, Aalborg, Denmark;

关键词: Atrial fibrillation;    Mixed-methods;    Healthcare professionals;    Qualitative;    Questionnaire;    Primary care;    Brazil;    LMIC;   

DOI  :  10.1186/s12872-022-02927-9

 received in 2022-03-21, accepted in 2022-10-29,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundAtrial fibrillation (AF) negatively impacts health systems worldwide. We aimed to capture perceptions of and barriers and facilitators for AF care in Brazilian primary care units (PCUs) from the perspective of healthcare professionals (HCPs).MethodsThis mixed-methods, cross-sectional study utilised an exploratory sequential design, beginning with the quantitative data collection (up to 18 closed questions) immediately followed by a semi-structured interview. HCPs were recruited from 11 PCUs in the Sao Paulo region and included managers, physicians, pharmacists, nurses and community health agents. Descriptive statistics were used to present findings from the quantitative questionnaire and inductive analysis was used to identify themes from the qualitative data.ResultsOne hundred seven HCPs were interviewed between September 2019 and May 2020. Three main themes were identified that encapsulated barriers and facilitators to AF care: access to care (appointments, equipment/tests and medication), HCP and patient roles (HCP/patient relationship and patient adherence) and the role of the organisation/system (infrastructure, training and protocols/guidelines). Findings from the qualitative analysis reinforced the quantitative findings, including a lack of AF-specific training for HCPs, protocols/guidelines on AF management, INR tests in the PCUs, patient knowledge of AF management and novel oral anticoagulants (NOACs) as key barriers to optimal AF care.ConclusionsDevelopment and implementation of AF-specific training for PCU HCPs are needed in Brazil, along with evidence-based protocols and guidelines, educational programmes for patients, better access to INR tests for patients taking warfarin and availability of NOACs.

【 授权许可】

CC BY   
© The Author(s) 2022

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