Key result
Waiting-room AF self-screening stations double new AF diagnoses to ~22 cases per 1000 patients.
Why the study?
The study was conducted to determine whether AF self-screening stations in general practice waiting rooms improve AF screening, diagnosis, and stroke risk management.
Does an AF self-screening station in general practice waiting rooms improve AF screening and diagnosis rates in patients aged 65 years or older?
Cross-Sectional (n=7,849)
Yes
Does an AF self-screening station in general practice waiting rooms improve AF screening and diagnosis rates in patients aged 65 years or older?
Implementation of AF self-screening stations in general practice waiting rooms doubled the incidence of newly diagnosed AF compared to standard care.
AF self-screening stations may increase detection in primary care; hypothesis-generating and should not yet change practice without randomized confirmation.
OBJECTIVE: To assess whether atrial fibrillation (AF) self-screening stations in general practice waiting rooms improve AF screening, diagnosis, and stroke risk management. DESIGN, SETTING: Intervention study (planned duration: twelve weeks) in six New South Wales general practices (two in rural locations, four in greater metropolitan Sydney), undertaken during 28 August 2020 - 5 August 2021. PARTICIPANTS: People aged 65 years or more who had not previously been diagnosed with AF, and had appointments for face-to-face GP consultations. People with valvular AF were excluded. INTERVENTION: AF self-screening station and software, integrated with practice electronic medical record programs, that identified and invited participation by eligible patients, and exported single-lead electrocardiograms and automated evaluations to patients' medical records. MAIN OUTCOME MEASURES: Screening rate; incidence of newly diagnosed AF during intervention and pre-intervention periods; prescribing of guideline-recommended anticoagulant medications. The incidence of newly diagnosed AF during the pre-intervention period was 11 cases per 1000 eligible patients; during the intervention period, it was 22 per 1000 eligible patients (screen-detected: 17 per 1000 eligible patients; otherwise detected: 4.6 per 1000 eligible patients). Prescribing of oral anticoagulation therapy for people newly diagnosed with AF and high stroke risk was similar during the pre-intervention (20 of 24, 83%) and intervention periods (46 of 54, 85%). CONCLUSIONS: AF self-screening in general practice waiting rooms is a feasible approach to increasing AF screening and diagnosis rates by reducing time barriers to screening by GPs. AF self-screening could reduce the number of AF-related strokes. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12620000233921 (prospective).
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Giskes et al. (2022) conducted a cross-sectional in Atrial fibrillation (n=7,849). Atrial fibrillation self-screening station and software vs. Pre-intervention period (standard care) was evaluated on Incidence of newly diagnosed atrial fibrillation (cases per 1000 eligible patients). Implementation of atrial fibrillation self-screening stations in general practice waiting rooms doubled the incidence of newly diagnosed AF from 11 to 22 cases per 1000 eligible patients.
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