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Pharmacists detecting atrial fibrillation (PDAF) in primary care during the influenza vaccination season: a multisite, cross-sectional screening protocol
  1. Emma L Veale1,
  2. Adrian J Stewart2,
  3. Alistair Mathie3,
  4. Satvinder K Lall4,
  5. Melanie Rees-Roberts5,
  6. Vilius Savickas3,
  7. Sukvinder K Bhamra3,
  8. Sarah A Corlett3
  1. 1 Medway School of Pharmacy, University of Kent and University of Greenwich, Chatham Maritime, Kent, United Kingdom
  2. 2 Cardiology, Medway Maritime Hospital, Kent, UK
  3. 3 Medway School of Pharmacy, University of Kent and University of Greenwich, Chatham Maritime, Kent, United Kingdom
  4. 4 Reach Healthcare, Walderslade Village Surgery, Chatham, UK
  5. 5 Centre for Health Services Studies, University of Kent, Kent, UK
  1. Correspondence to Dr Emma L Veale; e.l.veale{at}kent.ac.uk

Abstract

Introduction Atrial fibrillation (AF) affects >6% of people aged 65 years or older. Left undetected and untreated, patients may develop significant cardiovascular complications and have a fivefold increased risk of suffering a stroke. For 40% of all sufferers, AF can be asymptomatic. Every year in the UK, £2.2 billion is spent on AF-related strokes, so there is an urgent need to improve early detection of AF. This study aims to determine the feasibility of using trained clinical pharmacists based in general practices, to screen for AF, using pulse palpation and a single-lead ECG device on participants aged 65 years or older, attending influenza vaccination clinics.

Methods and analysis Seven clinical pharmacists will be trained by a cardiologist to pulse palpate and record single-lead ECGs using the AliveCor Kardia Mobile device. Quantitative analysis will assess the accuracy and ability of the clinical pharmacist to identify pulse irregularities using pulse palpation and to record and interpret a single-lead ECG. The level of agreement of pulse irregularities detected by pulse palpation will be compared with those detected by the single-lead ECG device, as will the level of agreement between the cardiologist and the device’s interpretation of the ECG. The proportion of people identified with AF (confirmed by the cardiologist) will be determined. Additional demographic data will be obtained from all participants through a questionnaire. Qualitative data will be captured from the participants, from the clinical pharmacists and from the general practitioners and practice staff to determine their views on this method of AF screening. We aim to recruit 600 participants across general practices within Kent.

Ethics and dissemination This protocol was approved by the London–Riverside Research Ethics committee. The findings of this study will be disseminated through forums including, but not limited to, peer-reviewed journals, national and international conferences.

  • cardiology
  • stroke
  • stroke medicine
  • preventive medicine
  • public health
  • healthy policy

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors ELV conceived the original concept of the study. ELV, AJS, AM, SAC, SKL, MR-R and SKB were involved in the design of the study. ELV, AM and VS were involved in the drafting of the article. All the authors were involved in the critical revision of the article and final approval of the submitted article. AM provided statistical expertise. SAC provided qualitative analysis expertise.

  • Funding This work was supported by a Medical Educational Grant from Bayer UK (UKBAY09170342a) and Faculty of Science Research Funding, University of Kent. Training for pharmacists was additionally supported by a grant from Kent Surrey and Sussex Community Education Providers Network (CEPN).

  • Disclaimer Bayer UK had no involvement in the design or implementation of this study.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval This protocol was approved by the London–Riverside Research Ethics committee and NHS Health Research Authority IRAS project ID: 232663.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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