Preventing stroke through primary care and public health: Identification and treatment of patients with Atrial Fibrillation in Enfield
PHE ePoster Library. Fida G. Sep 12, 2019; 274328; 137
Gosaye Fida
Gosaye Fida
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Abstract BackgroundEffective primary care could prevent stroke through the risk management of Atrial Fibrillation (AF). In Enfield, we estimated 1,342 patients with undiagnosed AF, and over 600 patients with AF who were not receiving standard treatment. A locally commissioned service, co-designed with Public Health and clinicians, commenced in October 2016, to detect AF and to optimise treatment.MethodFor detection, patients aged over 65 were invited to check their clinical risk of AF; suspected patients were offered advice and sent for confirmatory test and treatment initiation. For treatment optimisation, diagnosed AF patients were identified using GRASP-AF/APEL tools to review and optimise treatment. We evaluate the outcomes of this initiative as of September 2017 in comparison to the situation before October 2016.
Within a year, 9,292 patients age over 65 were invited to check their risk of AF. 497 patients with suspected AF were offered advice and forwarded for a confirmatory test to initiate treatment. 1,953 existing patients had their treatment optimised. At the end of the first year, prescribing for anticoagulants increased by 29% compared with the baseline year. Hospital admissions from Stroke and TIA significantly declined from 119.8 per 100,000 (95% CI:108.1- 132.4) in 2013/14 to 49.8 per 100,000 (95% CI: 42.5- 58.0) during intervention period.
Outcomes after the first year demonstrated that there is a reduction in hospital admissions related to stroke and TIA, and we achieved its intended objectives. North Central London STP is now upscaling this initiative to other CCGs. External funding details
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