Experts at Harefield Hospital have launched a project with local pharmacists to improve the diagnosis and treatment of patients with atrial fibrillation (AF).
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.
Ten community pharmacists in the surrounding north Hillingdon area have been trained to carry out detailed medicine reviews for patients with risk factors for developing AF – for example, elderly patients and people with high blood pressure or existing heart disease. And, for patients with existing AF, the pharmacists 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, which runs the largest arrhythmia service in the UK.
Dr Hussain says: “Of the 600 patients who will be screened in the project, we estimate that 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 it can be difficult to recover from strokes caused by AF.”
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, the elderly for example, who may not see a GP if they experience symptoms but will be happy to talk to a pharmacist about their medicines.”