Key result
Healthcare professionals identified a lack of AF-specific training, absence of protocols, limited access to INR tests, and poor patient knowledge as key barriers to optimal AF care in Brazil.
Why the study?
AF negatively impacts health systems worldwide, prompting an evaluation of perceptions, barriers, and facilitators for AF care in Brazilian primary care units from the perspective of healthcare professionals.
Cross-Sectional (n=107)
Yes
In the Brazilian public primary care system, significant barriers to atrial fibrillation management include inadequate healthcare professional training, lack of protocols, and limited access to INR testing and NOACs.
Barriers to AF care in Brazilian PCUs may compromise outcomes; leaves open effective implementation of training and protocols.
BACKGROUND: Atrial 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). METHODS: This 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. RESULTS: One 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. CONCLUSIONS: Development 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.
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Paschoal et al. (2022) conducted a cross-sectional in Atrial fibrillation (n=107). Atrial fibrillation care and management was evaluated on Perceptions, barriers, and facilitators for atrial fibrillation care. Healthcare professionals identified a lack of AF-specific training, absence of protocols, limited access to INR tests, and poor patient knowledge as key barriers to optimal AF care in Brazil.
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