{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T22:43:00Z","timestamp":1778539380310,"version":"3.51.4"},"reference-count":11,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,6,21]],"date-time":"2022-06-21T00:00:00Z","timestamp":1655769600000},"content-version":"vor","delay-in-days":81,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pulm. circ."],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>Although pulmonary hypertension (PH) is widely prevalent in India, care delivery for this condition has unique challenges in a lower middle\u2010income country (LMIC).\u00a0To describe care delivery for patients with PH and associated barriers in India.\u00a0We interviewed physicians across eight healthcare systems in India about PH clinical care using semi\u2010structured enquiries to understand care delivery and associated challenges in their specific practice as well as the associated health system. Qualitative analysis was performed using content analysis methodology.\u00a0Physicians reported that common causes for PH in their practice were rheumatic mitral valve disease, coronary artery disease, and congenital heart disease (CHD). No center had a dedicated PH program. Only one center had a specific protocol for PH management. Diagnostic evaluations were limited, and right heart catheterizations were recommended for patients with CHD. Pulmonary vasodilator therapy was used for severe symptoms or markers of severe disease. Agents used to treat PH were widely variable across physicians and prostacyclins are unavailable in India. Barriers included limited training in PH for physicians, lack of consensus guidelines for PH specific to LMIC, and lack of financial incentives for health care systems to organize dedicated PH programs. Other barriers included poor patient health literacy and socioeconomic barriers that limit ability to test and treat PH.\u00a0PH care delivery in India is variable with widely differing clinical practices. Dedicated training in PH management and establishing guidelines specific to LMIC like India can form the first step forward.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pul2.12094","type":"journal-article","created":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T09:10:55Z","timestamp":1652951455000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Current status and barriers in pulmonary hypertension care delivery in India: A qualitative analysis"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3608-4923","authenticated-orcid":false,"given":"Anand Reddy","family":"Maligireddy","sequence":"first","affiliation":[{"name":"Division of Cardiology Mayo Clinic Scottsdale Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Supriya","family":"Shore","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine,\u00a0Division of Cardiology, Frankel Cardiovascular Center University of Michigan Medical School Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Sreenivas Kumar","sequence":"additional","affiliation":[{"name":"Division of Cardiology Apollo Institute of Medical Sciences and Research Hyderabad India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Harikrishnan","sequence":"additional","affiliation":[{"name":"Division of Cardiology Sree Chitra Tirunal Institute for Medical Sciences and Technology Thiruvananthapuram India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Ajit Mullasari","sequence":"additional","affiliation":[{"name":"Division of Cardiology Madras Medical Mission Chennai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B. K.","family":"Sastry","sequence":"additional","affiliation":[{"name":"Division of Cardiology CARE Hospital Hyderabad India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sameer","family":"Gupta","sequence":"additional","affiliation":[{"name":"Division of Cardiology Metro Hospital and Heart Institute Noida India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikhil","family":"Choudhary","sequence":"additional","affiliation":[{"name":"Division of Cardiology Narayana Hospital Jaipur India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4265-8738","authenticated-orcid":false,"given":"Auras R.","family":"Atreya","sequence":"additional","affiliation":[{"name":"Division of Cardiology Institute of Cardiac Sciences and Research,\u00a0AIG Hospitals Hyderabad India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonali","family":"Arora","sequence":"additional","affiliation":[{"name":"Division of Cardiology Institute of Heart and Lung Transplant,\u00a0KIMS Hospital Hyderabad India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor M.","family":"Moles","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine,\u00a0Division of Cardiology, Frankel Cardiovascular Center University of Michigan Medical School Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vallerie V.","family":"Mclaughlin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine,\u00a0Division of Cardiology, Frankel Cardiovascular Center University of Michigan Medical School Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikas","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine,\u00a0Division of Cardiology, Frankel Cardiovascular Center University of Michigan Medical School Ann Arbor Michigan USA"},{"name":"Division of Cardiology Veteran Affairs Hospital Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,6,21]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01913-2018"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.15-0300"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2018.02.036"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.03.047"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10488-013-0528-y"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/1609406919874596"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/160940690600500107"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1188\/14.ONF.545-547"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2009.09.005"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv317"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.01.004"}],"container-title":["Pulmonary Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pul2.12094","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pul2.12094","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pul2.12094","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T07:27:07Z","timestamp":1692862027000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pul2.12094"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":11,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1002\/pul2.12094"],"URL":"https:\/\/doi.org\/10.1002\/pul2.12094","archive":["Portico"],"relation":{},"ISSN":["2045-8940","2045-8940"],"issn-type":[{"value":"2045-8940","type":"print"},{"value":"2045-8940","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4]]},"assertion":[{"value":"2022-03-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-05-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e12094"}}