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Pharmacy CV screening may benefit patients with suspected AF
Integrated CV screening identified patients who could potentially benefit from stroke prevention therapies due to presence of atrial fibrillation, according to recent findings published in Open Heart.
“Population-based screening for AF is a promising public heath strategy to prevent stroke,” Roopinder K. Sandhu, MD, from the division of cardiology at the University of Alberta in Canada, and colleagues wrote. “Recently, increasing data are emerging from different countries on AF screening in the community setting; however, more studies are needed on the optimal screening methods, settings and target population applicable to different health care systems.”
The PIAAF-Pharmacy prospective cohort study took place in Alberta and Ontario pharmacies between October 2014 and April 2015.
The program screened 1,145 individuals aged 65 years or older who attended 30 community pharmacies in Canada and were not receiving oral anticoagulants.
According to the study, eligible patients were screened for AF via a hand-held ECG device, had their BP measured, and were assessed for diabetes risk using the Canadian Diabetes Risk Questionnaire.
Patients with actionable AF, defined as unrecognized or untreated AF, were referred to a 6-week follow-up with a family physician and a 3-month visit at an AF clinic.
Patients with actionable AF who visited the AF clinic were asked if they were aware that AF could increase risk for stroke, if they were satisfied with their screening session and if they were satisfied with the educational material provided.
During the 6-month study, 29 participants (2.5%; 95% CI, 1.7-3.6) were identified as having actionable AF, 96% of which were newly diagnosed.
The mean age for patients with actionable AF was 77 years. Of this group, 58.6% were men and 93.1% had a CHA2DS2-VASc score 2.
The data showed that 54.9% of participants had a BP reading > 140/90 mm Hg and 44.4% had elevated risk for diabetes.
At the 6-week follow-up for those with actionable AF, 17% (n = 5) were started on oral anticoagulation, 50% had improved BP and 71% had confirmatory diabetes testing. At 3 months, eight more patients with actionable AF were prescribed oral anticoagulation, one received a left atrial appendage occlusion device (Watchman, Boston Scientific), one had hematuria and eight declined oral anticoagulation, the researchers wrote.
“Comprehensive, community-based screening for stroke risk factors is a promising public health strategy and to be effective must be coupled with a well-defined care pathway to ensure timely follow-up and treatment,” the researchers wrote. – by Dave Quaile
Disclosure: Sandhu reports no relevant financial disclosures. Three other researchers report financial ties with Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, Pfizer and Servier.