Community pharmacy could cut the delay in patients receiving a diagnosis of atrial fibrillation (AF), an NHS Trust pharmacist has told C+D.

 Patients with AF symptoms wait an average of two years before seeking advice, according to a  study carried out by research company Opinion Health in May and June.

The survey of 200 AF patients, commissioned by AF treatment Lixiana manufacturer Daiichi Sankyo, found that 68 per cent experienced an irregular heartbeat, dizziness or breathlessness before their first GP consultation. Lack of awareness of these symptoms was cited as the main reason for this delay, it said.

Sotiris Antoniou, a consultant pharmacist specialising in cardiovascular medicine at Barts Health NHS Trust, said there were a “number of roles” that community pharmacists could play to raise awareness of the “devastating” consequences of leaving irregular heartbeats unchecked.

If pharmacists suspected a patient of having AF, they should signpost them to a GP to receive an electrocardiogram test, said Mr Antoniou, who is involved in a scheme to help community pharmacists in London support AF patients who have been prescribed newer anticoagulants.

"Recognise sector's value"

The sector had an “extremely valuable role” to play in supporting medicines adherence among AF patients who had been prescribed anticoagulants, he said. Commissioners also needed to be a “bit more collaborative” and “recognise the value” that community pharmacists could bring to the care of these patients, he added.

Nice advised last year that aspirin should not be prescribed as a sole stroke prevention treatment for patients with AF, and Mr Antoniou said community pharmacists should “start questioning patients who buy aspirin to see whether they’re taking it for an irregular heart rate”.

Pharmacists could also check patients for symptoms themselves, Mr Antoniou stressed. “There’s nothing stopping a community pharmacist from feeling a patient’s pulse to see if it’s irregular.”

Daiichi Sankyo, which launched Lixiana last week (July 10), said its survey showed that “around half” of patients did not understand what AF was when they were diagnosed. “A similar proportion failed to realise the link between a heart condition and a possible stroke,” the manufacturer said.

Fourteen per cent of patients who experienced symptoms before their first consultation had waited five years or longer before seeing a doctor, it added.

In May, Alliance Healthcare chairman Mike Smith pointed to a clinical commissioning group’s lack of interest in a pharmacy atrial fibrillation pilot as proof that local commissioning was “not working”.

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