Screening for unknown atrial fibrillation in older people: a feasibility study in community pharmacies

Area of Science:

• Cardiology
• Public Health
• Geriatrics

Background:

• Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia, increasing morbidity and mortality risks, particularly in aging populations.
• Asymptomatic AF often goes undetected, highlighting the need for systematic screening to enable timely therapeutic interventions.
• Community pharmacies offer a potential venue for accessible AF screening services targeting older adults.

Purpose of the Study:

• To evaluate the technical feasibility of implementing an AF screening program in community pharmacies.
• To assess the acceptance of a freely offered AF screening service by older adults and pharmacy professionals.
• To identify undiagnosed cases of AF in the elderly population through community-based screening.

Main Methods:

• A 2-month screening initiative was conducted across 20 pharmacies in a mixed rural-urban Italian health district.
• A 30-second single-lead electrocardiogram (ECG) using a telemedicine device was employed for AF detection.
• Participants included older adults aged 70 years and above, with a focus on community pharmacy accessibility.

Main Results:

• Out of 335 eligible older adults, 289 (86.3%) participated in the screening program.
• Cardiologists deemed 80% of the obtained ECG tracings as readable for diagnostic purposes.
• The screening identified previously unknown cases of atrial fibrillation in 1.3% of the participants.

Conclusions:

• The proposed AF screening model demonstrated technical feasibility and high acceptance rates among both healthcare professionals and the public.
• Pharmacist training is recommended to enhance participation and optimize the performance of community pharmacy-based screening programs.
• Community pharmacies represent a viable and effective setting for systematic AF screening in older populations, facilitating early diagnosis and management.