ArticleBMC health services research2022
Healthcare provider and patient perspectives on access to and management of atrial fibrillation in the Northern Province, Sri Lanka: a rapid evaluation of barriers and facilitators to care.
Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 16 citations in OpenAlex.
- Cost-effectiveness of three screening strategies for atrial fibrillation in Sri Lanka: a decision-tree modelling analysis using community-based prevalence data.BMJ global health · 2026Article
- Development of a Rule-Based Chatbot for Supporting Family Caregivers After Psychiatric Hospital Discharge: An Exploratory Qualitative Study in Indonesia.Journal of multidisciplinary healthcare · 2026Article
- Inefficiencies identified in healthcare professional-to-patient handover practices for atrial fibrillation: a mixed-methods study in Brazil, China and Sri Lanka.BMJ global health · 2025Article
- Article
- Global voices on atrial fibrillation: South/Southeast Asia.Heart rhythm O2 · 2024Article
- The global burden of atrial fibrillation: Voices from Asia and Brazil.Heart rhythm O2 · 2024Article
- Mixed methods study protocol for combining stakeholder-led rapid evaluation with near real-time continuous registry data to facilitate evaluations of quality of care in intensive care units.Wellcome open research · 2023Article
- The pathway to diagnosis and follow-up care for atrial fibrillation in Sri Lanka: a descriptive longitudinal study.NIHR open research · 2023Article
- Article
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Authors and funding
18 authors at 11 institutions in 5 countries.
Funding
Abstract
backgroundAtrial fibrillation (AF) is the most common cardiac arrhythmia that affects 60 million people worldwide. Limited evidence on AF management exists from low- and middle-income countries and none from Sri Lanka. We aimed to investigate the existing AF care pathway and patients' perception on AF management to identify barriers and enablers for optimal AF care in Northern Province, Sri Lanka.
methodsA rapid evaluation was undertaken with use of qualitative methods. Local healthcare providers (HCPs) mapped the intended pathway of care for AF patients which was then explored and annotated through 12 iterative sessions with additional HCPs. Topics of inefficiencies identified from the finalised map were used to guide focus group discussions (FGDs) with AF patients. AF patients who were attending the anticoagulation clinic at the only tertiary hospital in Northern Province were recruited and invited to participate using purposive sampling. The topic guide was developed in collaboration with local clinicians and qualitative experts. FGDs were conducted in the native Tamil language and all sessions were recorded, transcribed verbatim and thematically analysed using a deductive approach.
resultsThe mapped pathway revealed inefficiencies in referral, diagnosis and ongoing management. These were explored through three FGDs conducted with 25 AF patients aged 25 to 70 years. Two key themes that contributed to and resulted in delays in accessing care and ongoing management were health seeking behaviours and atomistic healthcare structures. Four cross-cutting sub-themes identified were decision making, paternalistic approach to care, cost impacts and lifestyle impacts. These are discussed across 10 unique categories with consideration of the local context.
conclusionsStrengthening primary healthcare services, improving public health literacy regarding AF and building patient autonomy whilst understanding the importance of their daily life and family involvement may be advantageous in tackling the inefficiencies in the current AF care pathway in Sri Lanka.
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