Regional implementation of atrial fibrillation screening: benefits and pitfalls.

Autor:	Theunissen LJHJ; Netherlands Heart Network, De Run 4600, 5504 DB, Veldhoven, The Netherlands.; Máxima Medical Centre, De Run 4600, 5504DB, Veldhoven, The Netherlands.; Department of Electrical Engineering, Technical University, 5612 AZ, Eindhoven, The Netherlands., Abdalrahim RBEM; Netherlands Heart Network, De Run 4600, 5504 DB, Veldhoven, The Netherlands.; Department of Electrical Engineering, Technical University, 5612 AZ, Eindhoven, The Netherlands., Dekker LRC; Netherlands Heart Network, De Run 4600, 5504 DB, Veldhoven, The Netherlands.; Department of Electrical Engineering, Technical University, 5612 AZ, Eindhoven, The Netherlands.; Catharina hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands., Thijssen EJM; Máxima Medical Centre, De Run 4600, 5504DB, Veldhoven, The Netherlands., de Jong SFAMS; Elkerliek hospital, Wesselmanlaan 25, 5707 HA, Helmond, The Netherlands., Polak PE; St. Anna hospital, Bogardeind 2, 5664 EH, Geldrop, The Netherlands., van de Voort PH; Catharina hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands., Smits G; GP Organization PoZoB, Bolwerk 10-14, 5509 MH, Veldhoven, The Netherlands., Scheele K; GP Organization PoZoB, Bolwerk 10-14, 5509 MH, Veldhoven, The Netherlands., Lucas A; Diagnostics for You, Boschdijk 1119, 5626 AG, Eindhoven, The Netherlands., van Veghel DPA; Netherlands Heart Network, De Run 4600, 5504 DB, Veldhoven, The Netherlands.; Catharina hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands., Cremers HP; Netherlands Heart Network, De Run 4600, 5504 DB, Veldhoven, The Netherlands., van de Pol JAA; Netherlands Heart Network, De Run 4600, 5504 DB, Veldhoven, The Netherlands.; Department of Electrical Engineering, Technical University, 5612 AZ, Eindhoven, The Netherlands., Kemps HMC; Netherlands Heart Network, De Run 4600, 5504 DB, Veldhoven, The Netherlands.; Máxima Medical Centre, De Run 4600, 5504DB, Veldhoven, The Netherlands.; Department of Industrial Design, Eindhoven University of Technology, 5612 AZ, Eindhoven, The Netherlands.
Jazyk:	angličtina
Zdroj:	European heart journal. Digital health [Eur Heart J Digit Health] 2022 Oct 03; Vol. 3 (4), pp. 570-577. Date of Electronic Publication: 2022 Oct 03 (Print Publication: 2022).
DOI:	10.1093/ehjdh/ztac055
Abstrakt:	Aims: Despite general awareness that screening for atrial fibrillation (AF) could reduce health hazards, large-scale implementation is lagging behind technological developments. As the successful implementation of a screening programme remains challenging, this study aims to identify facilitating and inhibiting factors from healthcare providers' perspectives. Methods and Results: A mixed-methods approach was used to gather data among practice nurses in primary care in the southern region of the Netherlands to evaluate the implementation of an ongoing single-lead electrocardiogram (ECG)-based AF screening programme. Potential facilitating and inhibiting factors were evaluated using online questionnaires (N = 74/75%) and 14 (of 24) semi-structured in-depth interviews (58.3%). All analyses were performed using SPSS 26.0. In total, 16 682 screenings were performed on an eligible population of 64 000, and 100 new AF cases were detected. Facilitating factors included 'receiving clear instructions' (mean ± SD; 4.12 ± 1.05), 'easy use of the ECG-based device' (4.58 ± 0.68), and 'patient satisfaction' (4.22 ± 0.65). Inhibiting factors were 'time availability' (3.20 ± 1.10), 'insufficient feedback to the practice nurse' (2.15 ± 0.89), 'absence of coordination' (54%), and the 'lack of fitting policy' (32%). Conclusion: Large-scale regional implementation of an AF screening programme in primary care resulted in a low participation of all eligible patients. Based on the perceived barriers by healthcare providers, future AF screening programmes should create preconditions to fit the intervention into daily routines, appointing an overall project lead and a General Practitioner (GP) as a coordinator within every GP practice. Competing Interests: Conflict of interest: Despite the funding of the single-lead ECG-based devices by Bayer and Boehringer Ingelheim, these pharmaceutical companies were not involved in the implementation or evaluation of the screening programme, and they had no involvement in evaluating and analysing the data or writing this manuscript. The authors declare there were no further conflicts of interest. (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
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