Health Care Workers' Preferences in the Delivery of Atrial Fibrillation Screening: A Systematic Review

Health care workers (HCWs) play a crucial role in the success of atrial fibrillation (AF) screening programs. However, screening for AF remains underused due to organisational barriers, such as time constraints, user knowledge of the intervention, workforce constraints and turnover and availability of resources. Therefore, it is important to understand the preferences of HCWs on how to best integrate AF screening in routine practice.

Five databases were systematically searched for studies that reported on HCWs' opinions, thoughts, and preferences of screening published between January 2013, and August 2023 were included. An updated search was conducted in July 2025. An inductive thematic analysis was conducted, supported by a convergent qualitative-quantitative synthesis. Study quality was assessed using the mixed-methods appraisal tool.

Twenty-six studies met the inclusion criteria. Most studies were AF-focused with Australia having the highest representation of studies. Two overarching themes were identified: (1) screening preferences (device, frequency of screening, and population) and (2) implementation of screening into practice (change management, governance, communication, costs, and infrastructure). While HCWs broadly supported electrocardiogram-based screening tools and integration into existing workflows, preferences varied across professional groups and settings, particularly regarding role expansion, remuneration, and organisational readiness.

HCWs broadly support AF screening, but differ in expectations regarding delivery roles, resources, and system readiness. Aligning AF screening programs with workforce preferences and organisational capacity is essential for scalable and sustainable implementation.