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Patients' views about screening for atrial fibrillation (AF): a qualitative study in primary care

Patients' views about screening for atrial fibrillation (AF): a qualitative study in primary care
Patients' views about screening for atrial fibrillation (AF): a qualitative study in primary care
OBJECTIVES:
There has been increased interest in screening for atrial fibrillation (AF) with commissioned pilot schemes, ongoing large clinical trials and the emergence of inexpensive consumer single-lead ECG devices that can be used to detect AF. This qualitative study aimed to explore patients' views and understanding of AF and AF screening to determine acceptability and inform future recommendations.

SETTING:
A single primary care practice in Hampshire, UK.

PARTICIPANTS:
15 participants (11 female) were interviewed from primary care who had taken part in an AF screening trial. A semistructured interview guide was used flexibly to enable the interviewer to explore any relevant topics raised by the participants. Interviews were recorded, transcribed verbatim and analysed using inductive thematic analysis.

RESULTS:
Participants generally had an incomplete understanding of AF and conflated it with other heart problems or with raised blood pressure. With regards to potential drawbacks from screening, some participants considered anxiety and the cost of implementation, but none acknowledged potential harms associated with screening such as side effects of anticoagulation treatment or the risk of further investigations. The screening was generally well accepted, and participants were generally in favour of engaging with prolonged screening.

CONCLUSIONS:
Our study highlights that there may be poor understanding (of both the nature of AF and potential negatives of screening) among patients who have been screened for AF. Further work is required to determine if resources including decision aids can address this important knowledge gap and improve clinical informed consent for AF screening.
atrial fibrillation, general practice, qualitative research, screening
2044-6055
e033061
Lown, Mark
4742d5f8-bcf3-4e0b-811c-920e7d010c9b
Wilcox, Christopher
e2c4c36a-e2e5-43a5-9fd6-7198cc15dd53
Hughes, Stephanie
a6d39500-67ff-4d7a-a1dc-8e42f80945ff
Santer, Miriam
3ce7e832-31eb-4d27-9876-3a1cd7f381dc
Lewith, George
0fc483fa-f17b-47c5-94d9-5c15e65a7625
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Lown, Mark
4742d5f8-bcf3-4e0b-811c-920e7d010c9b
Wilcox, Christopher
e2c4c36a-e2e5-43a5-9fd6-7198cc15dd53
Hughes, Stephanie
a6d39500-67ff-4d7a-a1dc-8e42f80945ff
Santer, Miriam
3ce7e832-31eb-4d27-9876-3a1cd7f381dc
Lewith, George
0fc483fa-f17b-47c5-94d9-5c15e65a7625
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777

Lown, Mark, Wilcox, Christopher, Hughes, Stephanie, Santer, Miriam, Lewith, George, Moore, Michael and Little, Paul (2020) Patients' views about screening for atrial fibrillation (AF): a qualitative study in primary care. BMJ Open, 10 (3), e033061, [e033061]. (doi:10.1136/bmjopen-2019-033061).

Record type: Article

Abstract

OBJECTIVES:
There has been increased interest in screening for atrial fibrillation (AF) with commissioned pilot schemes, ongoing large clinical trials and the emergence of inexpensive consumer single-lead ECG devices that can be used to detect AF. This qualitative study aimed to explore patients' views and understanding of AF and AF screening to determine acceptability and inform future recommendations.

SETTING:
A single primary care practice in Hampshire, UK.

PARTICIPANTS:
15 participants (11 female) were interviewed from primary care who had taken part in an AF screening trial. A semistructured interview guide was used flexibly to enable the interviewer to explore any relevant topics raised by the participants. Interviews were recorded, transcribed verbatim and analysed using inductive thematic analysis.

RESULTS:
Participants generally had an incomplete understanding of AF and conflated it with other heart problems or with raised blood pressure. With regards to potential drawbacks from screening, some participants considered anxiety and the cost of implementation, but none acknowledged potential harms associated with screening such as side effects of anticoagulation treatment or the risk of further investigations. The screening was generally well accepted, and participants were generally in favour of engaging with prolonged screening.

CONCLUSIONS:
Our study highlights that there may be poor understanding (of both the nature of AF and potential negatives of screening) among patients who have been screened for AF. Further work is required to determine if resources including decision aids can address this important knowledge gap and improve clinical informed consent for AF screening.

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More information

Accepted/In Press date: 27 February 2020
e-pub ahead of print date: 18 March 2020
Keywords: atrial fibrillation, general practice, qualitative research, screening

Identifiers

Local EPrints ID: 440985
URI: http://eprints.soton.ac.uk/id/eprint/440985
ISSN: 2044-6055
PURE UUID: a20e6b4c-a78d-4b74-af09-cb81bffa606b
ORCID for Mark Lown: ORCID iD orcid.org/0000-0001-8309-568X
ORCID for Miriam Santer: ORCID iD orcid.org/0000-0001-7264-5260
ORCID for Michael Moore: ORCID iD orcid.org/0000-0002-5127-4509

Catalogue record

Date deposited: 26 May 2020 16:32
Last modified: 10 Jan 2022 03:04

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Contributors

Author: Mark Lown ORCID iD
Author: Miriam Santer ORCID iD
Author: George Lewith
Author: Michael Moore ORCID iD
Author: Paul Little

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