Abstract 17322: The Impact of Pharmacy Outreach on Atrial Fibrillation Detection, Knowledge, and Medication Adherence in Hong Kong Elderly
Objectives: To estimate the prevalence and knowledge of atrial fibrillation (AF) in Hong Kong elderly population, and evaluate the effects of a pharmacy outreach intervention on AF knowledge and therapy adherence in those with AF.
Methods: We recruited subjects aged 65 or above from 26 elderly centers in Hong Kong between 2013-15. Screening of AF was done using a handheld ECG device to estimate the prevalence of AF. The baseline AF knowledge, risk factor control, medications adherence of AF subjects were recorded. AF knowledge was assessed using a novel tool. Education sessions and referral letters for anticoagulant initiation were provided in first follow up. The impacts of interventions were evaluated in follow up including reassessment of AF knowledge and medication adherence using the Morisky 8-item medication adherence scale. Patients with ≥ 2 points were considered medication non-adherent (lower scores reflect better medication adherence).
Results: 147 out of 2767 subjects (5.3%) were detected with AF, and almost all (5.1%) were newly diagnosed AF. The mean age of AF patients was 80.3 ± 7.1 years old as compared to non-AF (77.2 ± 7.3, P=0.004). Over 70% were female in both groups (p = 0.300) and 51.1% of AF patients had no education versus 37.2% in non-AF patients (p = 0.078). Those with AF were more likely to be aged >85 (OR=2.54), male (OR=1.65), and have hypertension (OR=1.55). Mean CHA2DS2VASc score was 3.77 ± 1.32, and 97.3% had a score ≥ 2. Mean score for correct AF knowledge items was 7.9%: Those with AF had a slightly higher score (12.8% vs. 7.8% for non-AF population, p= 0.14). AF knowledge improved from 12.8% to 37.6% after intervention (p<0.001) in those with AF. The mean score of Morisky 8-item medication adherence scale fell from 1.96 to 1.23 after the intervention demonstrating significant improvement in medication adherence (p =0.008).
Conclusions: The prevalence of AF in this elderly Chinese population was similar to that found in other countries, and more frequent in very elderly, male, and hypertensive subjects. Almost all was previously unknown and at high enough risk of stroke to require anticoagulant. The pharmacy outreach service had significant impacts with improved AF knowledge and medication adherence post-intervention in those with AF.
Author Disclosures: B. Wong: None. A. Cheng: None. E. Yip: None. A. Wong: None. B. Wong: None. B. Yan: None. B. Freedman: None. V. Lee: None.
- © 2016 by American Heart Association, Inc.