How Community Pharmacists Can Screen for Atrial Fibrillation

When a screening program is proposed, policymakers have some questions: does screening improve detection of the target diagnosis, and is systematic screening better than opportunistic identification?

Atrial fibrillation (AF) guidelines advocate screening because it is cost effective and reduces prospective adverse outcomes associated with AF.

Recently, a team of researchers described how pharmacists have been able to screen for AF in community pharmacies. In the study, 9 pharmacists conducted interviews either face-to-face in the pharmacy or via telephone with 1000 patients aged 65 years or older who were at risk for AF but had no previous AF diagnosis.

The pharmacists employed handheld, iPhone-based AliveCor Heart Monitor, and most of them worked with local physicians to demonstrate the electrocardiogram technology.

Among the patients screened, pharmacists found that 1.5 % had previously undiagnosed AF.

The researchers noted 4 key take-home points:

· The iPhone electrocardiogram technology was easy-to-use, stimulating interest among pharmacists, patients, and doctors. Patients were willing to undergo screening and accept AF education from pharmacists.

· Pharmacists reported increased job satisfaction and better customer relations after completing this study.

· Some barriers with workflow management, time, and dealing with newly diagnosed customers were identified. Since this was a study, completion of paperwork was also a barrier.

· The project would need funding to be expanded and sustainable.

Many pharmacists indicated that they offered the AF screening in conjunction with other health screening, which made the process more efficient and also improved patient satisfaction. The study authors reported that this direct approach seemed acceptable to patients and increased screening uptake.

The researchers suggested that additional research focusing on the feasibility and cost effectiveness of combined cardiovascular screening in community pharmacies may shed light on how to broaden these services.

The study appeared ahead of print in the International Journal of Clinical Pharmacy.