Screening Education And Recognition in Community pHarmacies of Atrial Fibrillation to prevent stroke in an ambulant population aged ≥65 years (SEARCH-AF stroke prevention study): a cross-sectional study protocol
- Nicole Lowres1,2,3,
- Saul Benedict Freedman1,2,3,
- Julie Redfern3,4,
- Andrew McLachlan5,6,
- Ines Krass6,
- Alexandra Bennett5,6,
- Thomas Briffa7,
- Adrian Bauman8,
- Lis Neubeck3,4
- 1Department of Cardiology, Concord Repatriation General Hospital, Sydney, Australia
- 2Vascular Biology, Anzac Research Institute, Sydney, Australia
- 3Sydney Medical School, University of Sydney, Sydney, Australia
- 4The George Institute for Global Health, Sydney, Australia
- 5Centre for Education and Research on Aging, Concord Repatriation General Hospital, Sydney, Australia
- 6Faculty of Pharmacy, University of Sydney, Sydney, Australia
- 7School of Population Health, University of Western Australia, Perth, Australia
- 8School of Public Health, University of Sydney, Sydney, Australia
- Correspondence to Nicole Lowres;
- Received 23 April 2012
- Accepted 21 May 2012
- Published 25 June 2012
Background Atrial fibrillation (AF) is associated with a high risk of stroke and may often be asymptomatic. AF is commonly undiagnosed until patients present with sequelae, such as heart failure and stroke. Stroke secondary to AF is highly preventable with the use of appropriate thromboprophylaxis. Therefore, early identification and appropriate evidence-based management of AF could lead to subsequent stroke prevention. This study aims to determine the feasibility and impact of a community pharmacy-based screening programme focused on identifying undiagnosed AF in people aged 65 years and older.
Methods and analysis This cross-sectional study of community-based screening to identify undiagnosed AF will evaluate the feasibility of screening for AF using a pulse palpation and handheld single-lead electrocardiograph (ECG) device. 10 community pharmacies will be recruited and trained to implement the screening protocol, targeting a total of 1000 participants. The primary outcome is the proportion of people newly identified with AF at the completion of the screening programme. Secondary outcomes include level of agreement between the pharmacist's and the cardiologist's interpretation of the single-lead ECG; level of agreement between irregular rhythm identified with pulse palpation and with the single-lead ECG. Process outcomes related to sustainability of the screening programme beyond the trial setting, pharmacist knowledge of AF and rate of uptake of referral to full ECG evaluation and cardiology review will also be collected.
Ethics and dissemination Primary ethics approval was received on 26 March 2012 from Sydney Local Health District Human Research Ethics Committee—Concord Repatriation General Hospital zone. Results will be disseminated via forums including, but not limited to, peer-reviewed publication and presentation at national and international conferences.
Clinical trials registration number ACTRN12612000406808.
To cite: Lowres N, Freedman SB, Redfern J, et al. Screening Education And Recognition in Community pHarmacies of Atrial Fibrillation to prevent stroke in an ambulant population aged ≥65 years (SEARCH-AF stroke prevention study): a cross-sectional study protocol. BMJ Open 2012;2:e001355. doi:10.1136/bmjopen-2012-001355
Contributors SBF conceived the original concept of the study. All authors contributed to the design of the study, are involved in the implementation of the project and have read and approved the final manuscript.
Funding This work was supported by an Investigator-Initiated Grant from Bristol-Myers Squibb/Pfizer and a small project award from Boehringer-Ingelheim. JR is funded by a Postdoctoral Fellowship co-funded by the NHMRC and National Heart Foundation (632933). LN is an NHMRC early career fellow (APP1036763).
Competing interests Financial disclosures for SBF include Servier Australia (regarding Ivabradine—consultancy, honoraria, travel support); Bayer Australia (regarding Rivaroxaban—consultancy, honoraria) and Boehringer-Ingelheim (regarding Dabigatran—travel support, research grants). Financial disclosures for AM include Pharmaceutical Society of Australia (travel support) and Australian Antidoping Research Panel (Board Member).
Ethics approval Ethics approval was provided by Sydney Local Health District Human Research Ethics Committee—Concord Repatriation General Hospital zone (reference number: HREC/11/CRGH/274).
Provenance and peer review Not commissioned; externally peer reviewed.
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