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GPs could screen for AF during flu clinics, researchers suggest



Digital screening for atrial fibrillation at flu vaccination clinics may be a cost effective way for GPs to target at risk groups, say UK researchers. 

A study done in four GP practices in Kent over two flu seasons offered patients over the age of 65 a free heart rhythm check when they attended a flu vaccine clinic.

GP pharmacists were trained to carry out the screening which was done in more than 600 patients using with pulse and single lead ECG mobile device.

Reporting in PLoS Medicine, the team found a total prevalence of atrial fibrillation of 4.3%.

All those found to have atrial fibrillation qualified for anticoagulation and were more likely to be male (57.7%), to be older, and have a higher rate of co-morbidities including hypertension and diabetes.

Overall clinical pharmacists using the mobile device were able to detect 24 out of 26 possible atrial fibrillation diagnoses when compared with a cardiologist.

Using the digital technology there were fewer false positives than using pulse palpation alone (7.8% vs 2.6%).

The researchers also said that clinical pharmacists could potentially to treat and manage both the condition and the associated risk factors linked to other coexisting diseases and can provide patient education.

Study leader Dr Emma Veale from the Medway School of Pharmacy said the study showed that detecting atrial fibrillation using automated technology during flu vaccination clinics is a feasible approach.

‘Further studies are needed to investigate how to broaden AF screening to those at-risk who do not participate in the influenza vaccination and to explore the key barriers outlined by policymakers, which have delayed the adoption of a national AF screening programme.’

Currently the UK National Screening Committee does not recommend a screening programme for atrial fibrillation because it is not known if screening is more beneficial than the current approach and how effective treatment is for people diagnosed with the condition through screening.

Guidance published by NICE in 2019 found there is currently not enough evidence to recommend the routine adoption of single lead ECG devices for single time point atrial fibrillation testing in primary care and more research was needed.