Screening for undiagnosed atrial fibrillation in community pharmacies using mobile electrocardiogram technology: a quasi-experimental cross-sectional study (PREVENIM ICTUS).

BACKGROUND

Atrial fibrillation (AF) is a common, often silent, arrhythmia that markedly increases stroke risk yet remains undiagnosed in many high-risk adults. Mobile electrocardiogram technology in community pharmacies has detected 1-5% new AF internationally, but real-world pharmacist-led data in Southern Europe are scarce. Our study screened adults ≥ 55 years with cardiovascular risk factors in Spanish pharmacies to determine the frequency of undiagnosed AF and facilitate early stroke prevention.

METHODS

A quasi-experimental multicenter cross-sectional study was conducted in Community Pharmacies, Health Centers and Auxiliary Clinics in the Basic Health Area of Sagunto and Puerto de Sagunto (Spain) between April and June 2024. Community pharmacy users aged 55 years or older, with at least one risk factor, were included: hypertension, diabetes, heart failure, coronary heart disease, chronic kidney disease, BMI > 30 kg/m2, obstructive sleep apnea and who had signed the informed consent form.

PRIMARY VARIABLE: 1-lead electrocardiogram (ECG) result.

RESULTS

784 users were included, with a mean age of 70.1 years (SD = 8.0). From the 62 (7.9%) users identified with an alteration in the 1-lead ECG, 36 (58.1%) corresponded to a possible AF. Of these, thirty-four were referred to the Health Centre for confirmation by 12-lead ECG. Six patients (17.6%) were diagnosed with AF.

CONCLUSIONS

Opportunistic AF screening in Community Pharmacies, using portable technology, is a viable strategy to identify potential cases of undiagnosed AF in the at-risk population, contributing to early diagnosis of the arrhythmia and thus to stroke prevention.

TRIAL REGISTRATION: Not applicable.