Screening for atrial fibrillation: a cross-sectional survey of healthcare professionals in primary care

Taggar, Jaspal; Coleman, Tim; Lewis, Sarah; Jones, Matthew

Abstract

Introduction:
Screening for atrial fibrillation (AF) in primary care has been recommended; however, the views of healthcare professionals (HCPs) are not known. This study aimed to determine the opinions of HCP about the feasibility of implementing screening within a primary care setting.

Methods:
A cross-sectional mixed methods census survey of 418 HCPs from 59 inner-city practices (Nottingham, UK) was conducted between October-December 2014. Postal and web-surveys ascertained data on existing methods, knowledge, skills, attitudes, barriers and facilitators to AF screening using Likert scale and open-ended questions. Responses, categorized according to HCP group, were summarized using proportions, adjusting for clustering by practice, with 95% C.Is and free-text responses using thematic analysis.

Results:
At least one General Practitioner (GP) responded from 48 (81%) practices. There were 212/418 (51%) respondents; 118/229 GPs, 67/129 nurses [50 practice nurses; 17 Nurse Practitioners (NPs)], 27/60 healthcare assistants (HCAs). 39/48 (81%) practices had an ECG machine and diagnosed AF in-house. Non-GP HCPs reported having less knowledge about ECG interpretation, diagnosing and treating AF than GPs. A greater proportion of non-GP HCPs reported they would benefit from ECG training specifically for AF diagnosis than GPs [proportion (95% CI) GPs: 11.9% (6.8–20.0); HCAs: 37.0% (21.7–55.5); nurses: 44.0% (30.0–59.0); NPs 41.2% (21.9–63.7)]. Barriers included time, workload and capacity to undertake screening activities, although training to diagnose and manage AF was a required facilitator.

Conclusion:
Inner-city general practices were found to have adequate access to resources for AF screening. There is enthusiasm by non-GP HCPs to up-skill in the diagnosis and management of AF and they may have a role in future AF screening. However, organisational barriers, such as lack of time, staff and capacity, should be overcome for AF screening to be feasibly implemented within primary care.

Citation

Taggar, J., Coleman, T., Lewis, S., & Jones, M. (2016). Screening for atrial fibrillation: a cross-sectional survey of healthcare professionals in primary care. PLoS ONE, 11(4), Article e0152086. https://doi.org/10.1371/journal.pone.0152086

• Journal Article Type: Article
• Acceptance Date: Mar 8, 2016
• Online Publication Date: Apr 1, 2016
• Publication Date: Apr 1, 2016
• Deposit Date: Apr 11, 2016
• Publicly Available Date: Apr 11, 2016
• Journal: PLoS ONE
• Electronic ISSN: 1932-6203
• Publisher: Public Library of Science
• Peer Reviewed: Peer Reviewed
• Volume: 11
• Issue: 4
• Article Number: e0152086
• DOI: https://doi.org/10.1371/journal.pone.0152086
• Keywords: Atrial fibrillation; Healthcare professionals; Primary care
• Public URL: https://nottingham-repository.worktribe.com/output/778128
• Publisher URL: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0152086
• Related Public URLs: http://creativecommons.org/licenses/by/4.0/
• Contract Date: Apr 11, 2016