Callanan Aileen, Bayat Farshid, Quinlan Diarmuid, Kearney Patricia M, Buckley Claire M, Smith Susan M, Bradley Colin P
School of Public Health, University College Cork, Cork, Republic of Ireland
Department of General Practice, University College Cork, Cork, Republic of Ireland.
BJGP Open. 2023 Jun 27;7(2). doi: 10.3399/BJGPO.2022.0110. Print 2023 Jun.
Atrial fibrillation (AF), the most common cardiac arrhythmia, is a major risk factor for stroke. AF is often asymptomatic, making it difficult to diagnose. Globally, stroke is a leading cause of morbidity and mortality. Opportunistic AF screening has been recommended in clinical practice within the Republic of Ireland (RoI) and internationally, though the optimal mode and location remains under investigation. Currently, there is no formal AF screening programme. Primary care has been proposed as a suitable setting.
To identify the facilitators and barriers to AF screening in primary care from the perspective of GPs.
DESIGN & SETTING: A qualitative descriptive study design was adopted. Fifty-four GPs were invited from 25 practices in the RoI to participate in individual interviews at their practices. Participants were from both rural and urban locations.
A topic guide was developed to guide the interview content towards identification of facilitators and barriers to AF screening. The interviews were conducted in person, audio-recorded, transcribed verbatim, and analysed using framework analysis.
Eight GPs from five practices participated in an interview. Three GPs, two male and one female, were recruited from two rural practices and five GPs, two male and three female, were recruited from three urban practices. All eight GPs expressed a willingness to engage in AF screening. Time pressures and the need for additional staff to support were identified as barriers. Programme structure and patient awareness campaigns and education were identified as facilitators.
The findings will help to anticipate barriers to AF screening and aid the development of clinical pathways for people with or at risk of AF. The results have been integrated into a pilot primary care-based screening programme for AF.
心房颤动（AF）是最常见的心律失常，是中风的主要危险因素。AF通常无症状，难以诊断。在全球范围内，中风是发病和死亡的主要原因。爱尔兰共和国（RoI）及国际上的临床实践均推荐进行机会性AF筛查，不过最佳模式和地点仍在研究中。目前尚无正式的AF筛查计划。初级保健被认为是一个合适的场所。
从全科医生的角度确定初级保健中AF筛查的促进因素和障碍。
采用定性描述性研究设计。从RoI的25家诊所邀请了54名全科医生在其诊所参加个人访谈。参与者来自农村和城市地区。
制定了一个主题指南，以指导访谈内容，确定AF筛查的促进因素和障碍。访谈采用面对面的方式进行，进行录音，逐字转录，并使用框架分析进行分析。
来自5家诊所的8名全科医生参加了访谈。3名全科医生，2名男性和1名女性，来自2家农村诊所，5名全科医生，2名男性和3名女性，来自3家城市诊所。所有8名全科医生都表示愿意参与AF筛查。时间压力和需要额外的工作人员支持被确定为障碍。计划结构以及患者宣传活动和教育被确定为促进因素。
这些发现将有助于预测AF筛查的障碍，并有助于为AF患者或有AF风险的人制定临床路径。研究结果已被纳入一项基于初级保健的AF筛查试点计划。
