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GP pulse checks could prevent 2000 strokes

Trial evidence shows that opportunistic pulse regularity checks in individuals aged 65 years and older increases detection of atrial fibrillation (Afib). However, this is not currently recommended by the National Screening Programme or implemented by most clinical commissioning groups (CCGs).

To evaluate the effect of a systematic programme to promote pulse regularity checks, electronic primary care patient records in 3 east London CCGs were analysed. Rates of pulse regularity checks and prevalence of Afib in individuals aged 65 years and older were compared from the pre-intervention period (2007-2011) with the post-intervention period (2012-2017).

Across the 3 CCGs, rates of pulse regularity checks increased from a mean of 7.3% pre-intervention to 66.4% post-intervention, achieving 93.1% in the final year. Age-standardised prevalence of Afib in individuals aged 65 years or older 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%. An additional 790 new cases of Afib were identified.

Reporting the findings in the British Journal of General Practice, the study authors conclude that organisational alignment, standardised data entry, peer-performance dashboards, and financial incentives rapidly and generally increased opportunistic screening with pulse regularity checks. They estimate that strokes were prevented in 28 individuals in City and Hackney, Tower Hamlets and Newham CCGs, where the study took place but say the intervention could prevent more than 2000 strokes if the figures are applied across the United Kingdom.


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