Abstract 19641: Community Pharmacist Led Atrial Fibrillation Screening Program Has the Potential to Improve Atrial Fibrillation Detection Rates and Reduce Stroke Risk
Introduction: The prevalence of atrial fibrillation (AF) in the UK is around 2%, affecting more than 10% of people aged over 80 years. AF is associated with a high risk of stroke which is preventable with use of appropriate anticoagulation. Early identification and evidence based management of AF results in a reduction in the incidence of stroke. Community pharmacists are ideally situated to facilitate the screening and diagnosis of AF.
Objective: To determine the feasibility of a community pharmacist led AF screening program in identifying undiagnosed AF and optimising anticoagulation in patients with known AF.
Method: Ten community pharmacists were trained to undertake screening of AF with a target of 600 participants to be enrolled. Participants included those aged 65 years and above with AF associated risk factors: heart failure, hypertension, diabetes, previous heart attack or peripheral vascular disease, previous stroke/transient ischaemic attack (TIA). The screening process involves using a handheld single-lead electrocardiograph device, Kardia (AliveCor) monitor and completing a specially designed AF screening tool. Patients are referred to a specialist arrhythmia clinic if they have AF detected on their Kardia ECG, the ECG is unable to be interpreted or if the patient has AF but is not anticoagulated.
Interim results: Over a period of four weeks a total of 173 patients have been included, 97 male, mean age 74±6.3 years, known AF (22), vascular disease (34), congestive heart failure (1), hypertension (148), diabetes (50), previous stroke, TIA or thromboembolism (9). Of 173 patients’ ECGs, 135 were normal, 18 were unable to be interpreted and 20 had possible AF. After further assessment of these ECGs, 10 met the criteria for clinic attendance. Of these 10, 6 patients have so far attended clinic, 4 patients required no further treatment and 2 patients have subsequently been initiated on anticoagulation.
Conclusion: These interim results are promising and we anticipate that this study will demonstrate that it is possible to identify patients in the community who were not previously known to have AF or optimise anticoagulation for those with diagnosed AF, thus improving AF detection and greatly reducing the risk of stroke.
Author Disclosures: Z.M. Khanbhai: None. S.E. Manning: None. W. Hussain: None.
- © 2016 by American Heart Association, Inc.