Raising awareness and early detection of atrial fibrillation, an experience resorting to mobile technology centred on informed individuals.

Autor: Cunha S; Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Campus Universitário, Quinta da Granja, Monte da Caparica, 2829-511, Caparica, Portugal. Electronic address: sara.af.cunha@outlook.pt., Antunes E; Serviço de Cardiologia, Hospital Santa Marta, EPE; Rua de Santa Marta, 1169-024, Lisboa, Portugal. Electronic address: ejpantunes@sapo.pt., Antoniou S; Barts Health NHS Trust, St Bartholomew's Hospital, W Smithfield, London, EC1A 7BE, United Kingdom. Electronic address: sotiris.antoniou@bartshealth.nhs.uk., Tiago S; Farmácia Sália, Praça do Bocage 98-99, Setúbal, Setúbal (S.Julião, N. Sra. da Anunciada e Sta. Ma da Graça), 2900-276, Setúbal, Portugal. Electronic address: salia.stb@farmalink.pt., Relvas R; Residência Sénior Egas Moniz, Avenida D. Manuel Martins, n.° 4. Maçã - Sampaio, 2970-585, Sesimbra, Portugal. Electronic address: rrelvas.1143@gmail.com., Fernandez-Llimós F; Research Institute for Medicines (iMED.ULisboa), Faculdade de Farmácia da Universidade de Lisboa (FFUL), Av. Prof. Gama Pinto, 1649-003, Lisboa, Portugal. Electronic address: f-llimos@ff.ulisboa.pt., Alves da Costa F; Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Campus Universitário, Quinta da Granja, Monte da Caparica, 2829-511, Caparica, Portugal; Research Institute for Medicines (iMED.ULisboa), Faculdade de Farmácia da Universidade de Lisboa (FFUL), Av. Prof. Gama Pinto, 1649-003, Lisboa, Portugal. Electronic address: alvesdacosta.f@gmail.com.
Jazyk: angličtina
Zdroj: Research in social & administrative pharmacy : RSAP [Res Social Adm Pharm] 2020 Jun; Vol. 16 (6), pp. 787-792. Date of Electronic Publication: 2019 Aug 20.
DOI: 10.1016/j.sapharm.2019.08.036
Abstrakt: Background: Atrial fibrillation (AF) is a cardiac arrhythmia responsible for one third of ischemic strokes. Early detection of AF plays an important role in preventing embolic stroke.
Objectives: This study aimed to test the feasibility of an awareness event including opportunistic screening for atrial fibrillation; and to test the reliability of the innovative portable electrocardiogram (ECG) device used.
Methods: An awareness campaign was held during two weeks, where individuals consenting to participate in a pharmacist-led detection event, received a manual pulse check, were clinically evaluated and subject to a single-lead electrocardiogram using AliveCor Kardia® mobile. ECGs highlighted as possible AF were confirmed by the cardiologist and those signalled with abnormalities in cardiac rhythm were referred to their physician. Data were collected in a password protected application and analyzed using SPSS, v.24. The Kardia® mobile's sensitivity and specificity was tested against the standard 12-lead ECG.
Results: The awareness event involved 223 individuals, among which 205 were screened. Mean age was 66 years (SD = 15) and hypertension was the most frequently reported (n = 107; 52.2%). Mean CHAD 2 DS 2 - VASc score was 3 (SD = 1.8). Cardiac irregularities were identified in 45 individuals, 14 confirmed to be new cases of AF (6.8%) by the cardiologist. The sensitivity and specificity were 90.9% and 97.4%.
Conclusion: Data suggests this device to be potentially useful for opportunistic early detection of AF, provided interprofessional collaboration is guaranteed so that suspect cases are adequately managed and in a timely way. Fourteen new cases of AF were identified in the population studied, suggesting the pharmacist working in a multiprofessional context, may have had an important role in preventing potential ischemic-related strokes with this initiative. All healthcare professionals involved in the patient pathway should play a more active role in contributing to better health outcomes, particularly within primary care.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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