Cribado oportunista del pulso irregular para la detección de fibrilación auricular asintomática en farmacias comunitarias de cataluña. proyecto: Pren-Te El Pols / Opportunistic screening of irregular pulse to detect asymptomatic atrial fibrillation in community pharmacies: TAKE YOUR PULSE PROJECT

RESUMEN

Objetivo: Cribado oportunista de pulso irregular desde las farmacias comunitarias en pacientes mayores de 60 años como indicador de fibrilación auricular asintomática y evaluación de la idoneidad del proceso en cuanto a su factibilidad e implementación. Material y métodos: Estudio observacional descriptivo transversal basado en la toma de pulso radial a pacientes asintomáticos. Profesionales sanitarios de un total de 240 farmacias comunitarias voluntarias y de 105 centros de salud realizaron la formación necesaria para adherirse a la campaña ‘Pren-te el pols’ de 40 días de duración. Los farmacéuticos comunitarios reclutaron a 4.729 sujetos y 666 fueron excluidos. Finalmente se cribaron 4.063 sujetos mayores de 60 años. Se registraron las diferentes variables en una plataforma online creada para el proyecto en la que se accedía mediante un usuario y contraseña. Además, se evaluó la idoneidad del proceso mediante una encuesta autoadministrada a los farmacéuticos participantes. Resultados: El 5,9% de los sujetos cribados presentaron pulso irregular, siendo la proporción de varones estadísticamente significativa respecto a la de mujeres. La media del grado de satisfacción de los farmacéuticos fue de 8,07/10. Conclusiones: El cribado de pulso irregular para la detección de fibrilación auricular asintomática en farmacias comunitarias presenta un alto grado de factibilidad para su incorporación sistemática en grupos de pacientes susceptibles. Además, incorpora la accesibilidad de la determinación al permitir el cribado de muestras amplias en periodos cortos de tiempo. No obstante, aspectos de gestión compartida, trabajando coordinadamente con los equipos de atención primaria, devienen imprescindibles para evaluar de manera fehaciente su efectividad real en el aumento de la tasa de diagnósticos de ciertas patologías prevalentes

ABSTRACT

Background: Atrial fibrillation is the most common arrhythmia. It is associated with a high morbidity and mortality. It increases fivefold the probability of suffering an ischemic stroke, which is the most serious and incapacitating one. Its early diagnosis and treatment improve its clinical outcome. Objective: This study aims to describe the proportion of irregular pulses found from community pharmacies in patients over 60 years as an indicator of asymptomatic atrial fibrillation and it also evaluates the suitability of the process in terms of its feasibility and implementation. Methods: It was conducted an observational, descriptive and cross-sectional study. It was based on taking the radial pulse (RP) of asymptomatic patients. For a period of 40 days, healthcare professionals from 240 community pharmacists and 105 health centres attended the training and joined the ‘Take your pulse’ campaign. Community pharmacies recruited 4,729 subjects, 666 were excluded. Finally, 4,063 subjects over 60 years were screened. It was created an online platform, which was accessed by validating a user code and password, to record the different variables. In addition, the suitability of the process was evaluated through a self-administered survey of participating pharmacists. The suitability of the organisational model was evaluated using a validated self-report questionnaire completed by the participating pharmacists. Results: An irregular pulse was found in 5.9 % of the subjects among whom the percentage of males was statistically significant. The average level of pharmacists satisfaction was 8.07/10. Conclusion: Irregular pulse screening to detect asymptomatic atrial fibrillation in community pharmacies has a high degree of feasibility to be incorporated systematically into groups of susceptible patients. In addition, it incorporates the accessibility of the determination by allowing the screening of large samples in short periods of time. However, some aspects related to sharing management and working in coordination with Primary Care teams become essential to measure reliably its real effectiveness in the diagnostic rate rise of certain prevalent diseases