Enhanced medicines use reviews to improve the detection and treatment of atrial fibrillation

Royal Brompton and Harefield NHS Foundation Trust

  • Run by Royal Brompton and Harefield NHS Foundation Trust, in partnership with local community pharmacists, the Atrial Fibrillation Association and the cardiology clinical lead for Hillingdon Clinical Commissioning Group.
  • A pharmacy project working across primary/tertiary care interfaces.
  • Aiming to improve the detection and treatment of atrial fibrillation.
  • Community pharmacists will undertake enhanced medicines use reviews for patients with risk factors for developing atrial fibrillation, including using an innovative electrocardiography (ECG) device which measures patients’ heart rate and rhythm.

Atrial fibrillation (AF) increases the risk of stroke, reduces quality of life, and increases morbidity and mortality. A third of patients who have AF are asymptomatic, which often leads to a delay in diagnosis. Too often AF is only detected when the patient presents with serious complications, such as a stroke. Anticoagulation reduces the risk of stroke, but data have shown that only around half of patients eligible for an anticoagulant actually receive one.

This project, led by a team at the Royal Brompton and Harefield NHS Foundation Trust, is looking at how the detection and treatment of AF can be improved via ‘enhanced’ medicines use reviews in community pharmacies. Community pharmacists currently provide medicines use reviews to patients and are ideally situated to facilitate the diagnosis of AF.

Ten community pharmacists will carry out detailed medicines reviews for patients with risk factors for developing AF, for example high blood pressure or diabetes and, in patients with existing AF, they will check that they are receiving optimised treatment and are taking anticoagulants. As part of the consultation, the pharmacists will use a portable electrocardiography (ECG) device, called an AliveCor monitor, to detect AF.

Patients who are found to have undiagnosed AF, are not appropriately anticoagulated, have poor heart rate control, or have high symptom burden, will be referred to the Arrhythmia Care Team at Harefield Hospital, where they will be reviewed and offered individualised treatment.

Contact details

For more information about this project, please contact Sally Manning, Specialist Arrhythmia Pharmacist, at Harefield Hospital.

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