Opportunistic pulse checks in primary care to improve recognition of atrial fibrillation : a retrospective analysis of electronic patient records
© British Journal of General Practice 2018..
BACKGROUND: Atrial fibrillation (AF) is an important and modifiable risk factor for stroke. Earlier identification may reduce stroke-related morbidity and mortality. Trial evidence shows that opportunistic pulse regularity checks in individuals aged ≥65 years increases detection of AF. However, this is not currently recommended by the National Screening Programme or implemented by most clinical commissioning groups (CCGs).
AIM: To evaluate the impact of a systematic programme to promote pulse regularity checks, the programme's uptake in general practice, and the prevalence of AF.
DESIGN AND SETTING: Retrospective analysis of electronic primary care patient records in three east London CCGs (City and Hackney, Newham, and Tower Hamlets) over 10 years.
METHOD: Rates of pulse regularity checks and prevalence of AF in individuals aged ≥65 years were compared from the pre-intervention period, 2007-2011, to the post-intervention period, 2012-2017.
RESULTS: Across the three CCGs, rates of pulse regularity checks increased from a mean of 7.3% pre-intervention to 66.4% post-intervention, achieving 93.1% (n = 58 722) in the final year. Age-standardised prevalence of AF in individuals aged ≥65 years increased significantly from a pre-intervention mean of 61.4/1000 to a post-intervention mean of 64.5/1000. There was a significant increase in a post-intervention trend to a final-year mean of 67.3/1000: an improvement of 9.6% (5.9/1000) with 790 additional new cases identified.
CONCLUSION: Organisational alignment, standardised data entry, peer-performance dashboards, and financial incentives rapidly and generally increased opportunistic screening with pulse regularity checks. This was associated with a significant increase in detection and prevalence of AF and is of public health importance.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:68 |
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| Enthalten in: |
The British journal of general practice : the journal of the Royal College of General Practitioners - 68(2018), 671 vom: 04. Juni, Seite e388-e393 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Cole, James [VerfasserIn] |
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| Links: |
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| Themen: |
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| Anmerkungen: |
Date Completed 06.09.2019 Date Revised 04.12.2021 published: Print Citation Status MEDLINE |
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| doi: |
10.3399/bjgp18X696605 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM284309281 |
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| 245 | 1 | 0 | |a Opportunistic pulse checks in primary care to improve recognition of atrial fibrillation |b a retrospective analysis of electronic patient records |
| 264 | 1 | |c 2018 | |
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| 500 | |a Date Revised 04.12.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © British Journal of General Practice 2018. | ||
| 520 | |a BACKGROUND: Atrial fibrillation (AF) is an important and modifiable risk factor for stroke. Earlier identification may reduce stroke-related morbidity and mortality. Trial evidence shows that opportunistic pulse regularity checks in individuals aged ≥65 years increases detection of AF. However, this is not currently recommended by the National Screening Programme or implemented by most clinical commissioning groups (CCGs) | ||
| 520 | |a AIM: To evaluate the impact of a systematic programme to promote pulse regularity checks, the programme's uptake in general practice, and the prevalence of AF | ||
| 520 | |a DESIGN AND SETTING: Retrospective analysis of electronic primary care patient records in three east London CCGs (City and Hackney, Newham, and Tower Hamlets) over 10 years | ||
| 520 | |a METHOD: Rates of pulse regularity checks and prevalence of AF in individuals aged ≥65 years were compared from the pre-intervention period, 2007-2011, to the post-intervention period, 2012-2017 | ||
| 520 | |a RESULTS: Across the three CCGs, rates of pulse regularity checks increased from a mean of 7.3% pre-intervention to 66.4% post-intervention, achieving 93.1% (n = 58 722) in the final year. Age-standardised prevalence of AF in individuals aged ≥65 years increased significantly from a pre-intervention mean of 61.4/1000 to a post-intervention mean of 64.5/1000. There was a significant increase in a post-intervention trend to a final-year mean of 67.3/1000: an improvement of 9.6% (5.9/1000) with 790 additional new cases identified | ||
| 520 | |a CONCLUSION: Organisational alignment, standardised data entry, peer-performance dashboards, and financial incentives rapidly and generally increased opportunistic screening with pulse regularity checks. This was associated with a significant increase in detection and prevalence of AF and is of public health importance | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a atrial fibrillation | |
| 650 | 4 | |a pulse | |
| 650 | 4 | |a screening | |
| 700 | 1 | |a Torabi, Payam |e verfasserin |4 aut | |
| 700 | 1 | |a Dostal, Isabel |e verfasserin |4 aut | |
| 700 | 1 | |a Homer, Kate |e verfasserin |4 aut | |
| 700 | 1 | |a Robson, John |e verfasserin |4 aut | |
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