Improving early detection of Atrial Fibrillation: Developing the role of Prescribing Pharmacists

This Bevan Exemplar project used smart ECG monitors in the development of the prescribing pharmacist role to improve the early detection of Atrial Fibrillation.

Background

Atrial fibrillation (AF) is a form of irregular heartbeat that increases a patient’s risk of stroke five-fold, and is estimated to contribute to one in five strokes in the UK. This stroke risk can be reduced significantly with appropriate medication. However, many patients show no symptoms, and up to a third of cases are undiagnosed, meaning that patients are not receiving vital treatment.

AliveCor ECG monitors have been shown to be more effective at detecting AF than routine pulse checks conducted by healthcare professionals.

Aims

• The aim of this project was to explore whether using smart technology to run a 30 second ECG trace through a mobile phone device could help improve the early detection of AF.

• A device was issued to each GP practice in the cluster.

• It was intended that the devices would be used to opportunistically test for AF in patients at high risk of developing the condition during routine GP-practice appointments

Challenges

Several challenges were met during the course of the project. Initially, it took time to understand point-of-care testing requirements for new technology. It became apparent that gaining wide-spread adoption of the technology across the cluster would be difficult, and it was decided to gather data for the use of the device by the cluster pharmacist, with the intention to cascade learning and good practice within the cluster.

Outcomes

The device was used to test 108 patients in routine medical appointments. Of these, 6 patients went on to be diagnosed with AF, and went on to receive appropriate treatment to reduce their stroke risk. It is unlikely that these patients would have been diagnosed were it not for this project.

Next steps

Following the positive findings of the project, the next steps are to promote the adoption of device use across the cluster, the health board and on a national scale, with the overall aim of improving AF detection, and subsequent treatment.

Did you know?

Atrial fibrillation is a contributing factor in up to 1 in 5 strokes in the UK, but one third of cases are currently undiagnosed.

Part of cohort Bevan Exemplar Projects 2018-19