Exploration of barriers and facilitators to initiating oral anticoagulants among patients with atrial fibrillation in Australian primary healthcare settings

Oral anticoagulants have established effectiveness in reducing the incidence of stroke and systemic embolism in patients with atrial fibrillation. However, underprescribing of oral anticoagulants ineligible patients with atrial fibrillation is frequently observed. This thesis aimed to explore barriers and facilitators to initiating oral anticoagulants among patients with atrial fibrillation in the Australian primary care settings. This doctoral research was undertaken in 4 phases, two reviews, an exploratory sequential mixed methods study, and a qualitative study. Barriers and facilitators related to the best available scientific evidence, clinical expertise and context, and patient values and preferences influence oral anticoagulant initiation.