Pharmacist-led Atrial Fibrillation initiative contributes to a 22% reduction in Stroke

Interface Clinical Services, an IQVIA business, supported a Health Care Organisation to reduce the number of atrial fibrillation related strokes through effective identification and management of patients.

Atrial fibrillation (AF) is the most common heart rhythm disturbance, affecting around 1.4 million people in the UK and people with AF are more at risk of having a stroke1. There are over 100,000 strokes each year in the UK resulting in nearly 38,000 deaths, with stroke a leading cause of death and disability in the UK2.

Interface pharmacists worked with the locality to review their patient population to identify those at risk of an AF related stroke. The project involved 38 practices which represented a combined population of 242,414. Funding was given by the pharmaceutical industry to deliver this work.

Following pharmacist review, the audit identified 486 patients to be considered for addition to the AF QOF register. This led to an initial increase in prevalence from 1.85% to 1.92% by the 12-week follow-up and a further increase to 1.98% by the end of the QOF year.

The percentage of high-risk patients receiving anticoagulation increased from 82.4% to 84.9% during the initial 12 week period with overall treatment rates for moderate and high risk patients increasing from 80.5% to 83.6%.

Predicted stroke incidence was reduced from 76.82 to 66.96 representing a cost saving to the NHS of ￡178,279 in the first year. Actual stroke admissions in the period following the review were 22% lower compared to the period prior to the review within the locality.

Structured implementation of NICE guidance reduced stroke incidence by improving the identification and management of patients with atrial fibrillation. Collaborative programmes of this nature are increasingly valuable in supporting the NHS to improve the quality of care for patients and ensuring appropriate allocation of NHS resources.

References:

1. Atrial fibrillation. NHS. Available at: https://www.nhs.uk/conditions/atrial-fibrillation/ (Accessed: May 2023).?

2 What is the prevalence of stroke and TIA in the UK? (updated January 2022) NICE. Available at: Prevalence | Background information | Stroke and TIA | CKS | NICE (accessed: May 2023)