20 research outputs found
Additional file 1: of Parents’ knowledge, attitudes and beliefs regarding sun protection in children: a qualitative study
Topic guide. (DOCX 14 kb
Additional file 2: of Exploring the clinically orientated roles of the general practice receptionist: a systematic review protocol
Medline search strategy. (DOCX 15 kb
Lettres sur la méthode de s'enrichir promptement, et de conserver sa santé, par la culture des végétaux exotiques
17 juillet 17701770/07/17 (T5)
Additional file 1 of The Clinical Teaching Fellow role: exploring expectations and experiences
Supplementary Material 1
Additional file 1: of Measurement of blood pressure for the diagnosis and management of hypertension in different ethnic groups: one size fits all
Diagnostic output of raw data at different BP thresholds. (DOCX 19 kb
Study flow chart.
BackgroundAtrial fibrillation (AF) is a major risk factor for stroke. To enable improvements to AF diagnosis and follow-up care, understanding current patient pathways and barriers to optimal care are essential. We investigated the patient care pathways and their drivers, and the impact of the COVID-19 pandemic on patient pathways in a middle-income country setting, Brazil.MethodsThis mixed-methods study in São Paulo, included adults (≥18y) with AF from 13 primary/secondary healthcare facilities. Surveys using baseline, follow-up (administered ≥two months after baseline) and COVID-19 questionnaires (quantitative), and three focus group discussions (FGDs) were conducted. Minimum sample size for the quantitative component was 236 and we aimed to reach saturation with at least three FGDs for the qualitative component. Descriptive statistics were used for quantitative data and a content analysis was used for qualitative data to identify themes related to AF diagnosis and follow-up care.Results267 participants completed the baseline questionnaire: 25% were diagnosed in primary care, 65% in an emergency or inpatient department. At follow-up (n = 259), 31% visited more than one facility for AF care, and 7% had no follow-up. Intervals between international normalised ratio (INR) tests were increased during the pandemic, and the number of healthcare visits and availability of medication were reduced. Seventeen patients participated in three FGDs and revealed that AF diagnosis often occurred following a medical emergency and patients often delay care-seeking due to misconceptions about AF symptoms. Long waiting times, doctor/patient interactions and health system factors, such as doctor availability and the referral system, influence where participants visited for follow-up care.ConclusionsLack of public awareness and underdeveloped primary healthcare lead to delayed diagnosis, which impacts clinical outcomes and excess patient and healthcare system costs. Health system, care-provider, and pandemic factors disrupt timely and effective continuity of care.</div