Pharmacist-led AF Screening in UK General Practice

Pavankumar Kamat

July 22, 2020

Screening for atrial fibrillation (AF) conducted by clinical pharmacists based in UK general practices was feasible, cost-effective and rated positively by patients. The findings were published in PLoS Medicine .

An AF screening strategy conducted by clinical pharmacists selectively targeted 604 people aged ≥65 years attending influenza vaccination clinics at participating general practitioner practices in the UK. Pharmacists received training from a cardiologist on pulse palpation, recording and interpreting a single-lead ECG (SLECG).

The sensitivity and specificity of AF diagnosis by clinical pharmacists using pulse palpation was 76.9 per cent (95% CI, 56.4%-91.0%) and 92.2 per cent (95% CI, 89.7%-94.3%), respectively. When SLECG was used in place of pulse palpation, the sensitivity and specificity increased to 88.5% (95% CI, 69.9%-97.6%) and 97.2% (95% CI, 95.5%-98.4%), respectively. At follow-up, new AF was diagnosed in 0.7% of participants and 0.5% were put on anticoagulants. New non-AF conditions, including left ventricular hypertrophy, were diagnosed in 4.6% of participants.

Pharmacist-led AF screening was found to be cost-effective in 71.8% and 64.3% of the estimates for SLECG and pulse palpation, respectively. The screening strategy received a positive response from 70% of participants, with all of them rating it either 'very good' or 'good'.

The authors said: "Future screening initiatives will require the involvement of HCPs based in general practices, in particular, clinical pharmacists. Their participation can assure the longevity of any future AF screening programmes."

Savickas V, Stewart AJ, Rees-Roberts M, Short V, Bhamra SK, Corlett SA, Mathie A, Veale EL. Opportunistic screening for atrial fibrillation by clinical pharmacists in UK general practice during the influenza vaccination season: A cross-sectional feasibility study. PLoS Med.2020;17(7):e1003197. doi: 10.1371/journal.pmed.1003197. PMID: 32678820.  Full text.

This article originally appeared on Univadis, part of the Medscape Professional Network.

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