Evidence map›Paper›PMID 40721744›Full record

ArticleBMC pulmonary medicine2025

Gaps in access to pulmonary hypertension care and opportunities for improvement: a multi-site qualitative study.

Kari R Gillmeyer, Sara Shusterman, Seppo T Rinne, A Rani Elwy, Renda Soylemez Wiener

Abstract readMulticenter Study
In one paragraph

Article in BMC pulmonary medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Clinical Updates in Pulmonary Hypertension.Reviews in cardiovascular medicine · 2026
    Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Kari R GillmeyerCenter for Health Optimization & Implementation Research, VA Boston Healthcare System, Boston, MA, USA. Kari.Gillmeyer@va.gov.ORCID http://orcid.org/0000-0002-5333-259X
Sara ShustermanCenter for Health Optimization & Implementation Research, VA Boston Healthcare System, Boston, MA, USA.
Seppo T RinneGeisel School of Medicine at Dartmouth, Lebanon, NH, USA.ORCID http://orcid.org/0000-0002-8662-1224
A Rani ElwyDepartment of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA.ORCID http://orcid.org/0000-0001-7088-3118
Renda Soylemez WienerCenter for Health Optimization & Implementation Research, VA Boston Healthcare System, Boston, MA, USA.ORCID http://orcid.org/0000-0001-7712-2135

Funding

Department of Veterans' Affairs, Australian Government CDA 22-140HSRD VA IK2 HX003700HSRD VA IK6 HX003765NCATS NIH HHS 1UL1TR001430U.S. Department of Veterans Affairs RCS 23-081
6 · The paper itself

Abstract

backgroundPulmonary hypertension (PH) is a progressive disease leading to right heart failure and early mortality. Early recognition of the disease and timely initiation of PH-specific therapies for qualifying PH subgroups are crucial for improving patient outcomes. Yet delays in diagnosis and treatment of PH persist. We aimed to explore patient and provider perspectives on access to and timeliness of PH care across the patient's entire health journey from symptom onset through follow-up care.

methodsWe conducted a multi-site qualitative study at three expert PH centers in the United States. We interviewed 41 key informants including 21 patients and 20 providers (physicians, physician assistants, PH pharmacists, and PH nurses). Guided by a conceptual model of the care continuum adapted to PH, we analyzed transcripts using a directed content analysis with both deductive (based on our conceptual model) and inductive coding.

resultsWe found barriers to timely access to PH care along the entire care continuum from symptom onset through receiving longitudinal PH care. Geographic barriers to care, limited non-expert PH knowledge, dismissal of patient's symptoms by providers, limited PH expert availability, and inadequate insurance coverage of PH medications emerged as the most prominent barriers to PH care access. Participants offered clear and specific solutions to address these care gaps, including establishing telementoring models to improve non-expert PH knowledge, building relationships between PH experts and community providers to bolster referral networks, leveraging technology to mitigate geographic barriers, and building satellite sites to expand access to PH experts.

conclusionsPatients with PH experience significant barriers to receiving timely PH care along their entire health journey. Comprehensive transformations to PH care delivery and health policies are needed to mitigate delays and improve quality of care for patients living with this disease.

Indexed as

Health Services AccessibilityHypertension, PulmonaryAdultAgedContinuity of Patient CareFemaleHumansMaleMiddle AgedQualitative ResearchUnited StatesDelayed diagnosisHealth services accessibilityPatient-centered carePulmonary hypertension

Identifiers

PMID40721744
PMCPMC12302599

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.