3 November 2015
Experts at Harefield Hospital have been awarded £75,000 to implement a project which aims to improve the diagnosis and treatment of patients with atrial fibrillation (AF) in the community.
The project is one of 21 initiatives selected by the Health Foundation to be part of its £1.5 million innovation programme, ‘Innovating for Improvement’. The Health Foundation is an independent charity working to improve the quality of healthcare in the UK.
Led by senior arrhythmia pharmacist, Sally Manning, and consultant cardiologist, Dr Wajid Hussain, the programme’s overall objective is to reduce the number of undiagnosed AF cases and the prevalence of stroke among AF patients.
AF is a heart condition that causes an irregular and often abnormally fast heart rate. It affects over 800,000 people in England and can cause symptoms such as palpitations, tiredness, breathlessness and dizziness. The way the heart beats in AF reduces its efficacy, which can cause blood clots that may lead to a stroke. AF can cause heart failure if it is not well controlled.
The funding will be used to support, train and provide equipment to 10 community pharmacists in the surrounding north Hillingdon area.
The pharmacists will carry out a detailed medicines review for patients with risk factors for developing AF – for example, elderly patients and people with high blood pressure or existing heart disease – and, in patients with existing AF, they will check that they are receiving optimised treatment and are taking anticoagulants.
As part of the consultation, the pharmacists will use a portable electrocardiography (ECG) device, called an AliveCor monitor, to detect AF. The AliveCor monitor is a small metal plate that is linked to a mobile phone or device. Patients place their fingers on the plate, which contains electrodes, and it records their heart rate and rhythm and automatically detects whether the patient is in normal rhythm or AF.
If a patient is diagnosed with AF or found to have inadequate AF treatment, they will be referred directly to the arrhythmia care team at Harefield Hospital, the largest arrhythmia service in the UK.
Dr Hussain said: “Of the 600 patients who will be screened in the project, we estimate than 10 per cent will require referral to Harefield for further management.
“We don’t want patients to be out there with AF and not know it. Some patients only find out they have the condition when they have a potentially life-threatening stroke, and strokes caused by AF can be difficult to recover from.
“We are thankful to the Health Foundation for providing the means for us to carry out this important project.”
Sally Manning added: “If this model is successful it could be applied to other community pharmacies all over the country. The programme will reach out to a population of patients, for example the elderly, who may not see a GP if they experience symptoms but will be happy to talk to a pharmacist about their medicines.”