Abstract
Purpose: Opportunistic pharmacy-based screening of atrial fibrillation (AF) appears effective, but the proportion of detected citizens is unknown. The aim of our real-life study was to determine rates of screening in a community population according to age group and gender. Methods: We conducted four community campaigns of pharmacy-based single-time point AF screening that involved individuals ≥65 years. We used a single-lead and hand-held device MyDiagnostick (6229 EV Maastricht, The Netherlands) that generates a 60-s ECG trace. All pharmacies of the communities (n = 54) were involved. Rates of screening were assessed on the base of the French National Institute for Statistics and Economic Studies data and were expressed as percentage and 95% Confidence interval (CI). Results: We screened 4208 individuals (Mean age, 74.2 ± 6.6 years; females, 60.2%). The screening rate in citizens aged ≥65 years was 17.2% (16.6–17.7), and higher in females than in males (17.9% [17.3–18.6] versus 16.0 [15.3–16.8], p < 0.001). The 70–74 age group showed the highest rate (25.7% [24.4–27]) compared to other groups. After 74 years, screening rates decreased steadily with age and dropped to 4.8% [3.8–6.1] in very elderly (≥90). Among the 188 (4.47%) positive screening, 117 (2.78%) showed an AF that was unknown in 53 (1.26%). Increasing age (OR: 1.05 [1.00–1.09], p = 0.04), male sex (OR: 4.30 [2.33–7.92], p < 0.0001) and high CHA2DS2-Vasc (OR: 1.59 [1.21–2.09], p = 0.0008) were independent predictors of unknown AF. Conclusion: Single-lead AF detection performed in community pharmacies result in screening one in six elderly citizens. Although male sex and elderly predicted unknown AF diagnosis, they were less involved in such designed campaigns.
Highlights
Atrial fibrillation (AF) is the most common sustained arrythmia and is characterized by a growing prevalence that increases steadily with age [1]
In the pooled population (≥65 years) of the three communities (n = 21,521), 3694 subjects have participated to the campaign giving a total screening rate of 17.2% (16.6–17.7)
We report real-life data of large campaigns of opportunistic AF screening setting in community pharmacies
Summary
Atrial fibrillation (AF) is the most common sustained arrythmia and is characterized by a growing prevalence that increases steadily with age [1]. ≥65 years of age [3]. Development of mobile health technologies provides opportunities to screen large group of population. Several studies assessed AF detection tools such as watches [5], smartphones [6] or hand-held devices [7]. These trials have been performed in primary care center, geriatric ward or pharmacies [8]. Efficiency in new AF detection deeply differ (0.7% to 9.5%) between opportunistic single-time screening [9] and multi-time screening in selected individuals [10].
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