Pharmacists could screen patients for AF during flu vaccination appointments, study suggests

A feasibility study indicates that screening for atrial fibrillation could be carried out at the same time as flu vaccinations, to increase early detection rates.

Atrial fibrillation monitor

Atrial fibrillation (AF) screening by pharmacists in primary care during flu vaccination appointments is a cost-effective strategy for early detection of the condition, a study published in the journal PLoS Medicine (17 July 2020) has suggested[1]
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The research team carried out a feasibility study during the 2017/2018 and 2018/2019 flu seasons at four GP practices in Kent, England. GP-based pharmacists were trained by a cardiologist to detect AF via pulse palpation, and record and interpret a single-lead electrocardiogram (ECG).

Overall, 604 participants aged 65 years and over were screened, and total prevalence of AF was 4.3%. Four patients were diagnosed with new AF and three started on anticoagulation.

The sensitivity and specificity of the pharmacists diagnosing AF using pulse palpation was 76.9% and 92.2%, respectively, and this rose to 88.5% and 97.2%, respectively, using the ECG.

The strategy was cost-effective in 71.8% and 64.3% of estimates for ECG and pulse palpation, respectively. Feedback from participants was generally positive.

The researchers said that, although there is no routine screening for AF in the UK, there had been calls to increase early detection.

“This work demonstrates a feasible approach to annual AF screening in primary care by clinical pharmacists using digital technology that could be readily adopted by general practices delivering annual influenza vaccinations to the over 65s and adapted to involve other HCPs [healthcare professionals],” they concluded.

References

[1] Savickas V, Stewart A, Rees-Roberts M et al. 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. doi: 10.1371/journal.pmed.1003197

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Citation
The Pharmaceutical Journal, PJ August 2020, Vol 305, No 7940;305(7940):DOI:10.1211/PJ.2020.20208264