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NIHR awards £3M towards AF screening/stroke prevention programme

last modified May 16, 2018 03:09 PM

A major research programme led by Prof Jonathan Mant has won £3,000,000 award from the National Institute for Health Research (NIHR) to investigate the value of screening to detect undiagnosed atrial fibrillation (AF).

AF is characterised by an irregular pulse. It is the most common disturbance of the heart rhythm and affects up to 10% of people over the age of 65. AF is linked to an increased risk of stroke, heart attack, dementia and premature death but many patients do not know that they have the condition. Once AF is detected, the risks can be reduced significantly by anticoagulation therapy that prevents blood clots.

At present, some GPs look for AF opportunistically by using a diagnostic device such as a hand-held electrocardiogram (ECG) or simply by taking the pulse of patients who may be visiting for any reason. However, this is only done in some general practices and not in a systematic way.

The new research programme will include the largest-ever randomised controlled trial to find out whether screening for AF in people aged 65 and over can prevent stroke and heart attacks, and whether this screening represents good value for money for the NHS.

The research will involve 120,000 patients aged over 65 in 300 general practices across England. Patients in 100 practices will undergo screening, and those in 200 practices will not. People who are found to have AF by the screening programme will be offered treatment with anticoagulant drugs to reduce their risk of stroke and heart attack. Both sets of patients will be followed up for five years to see whether screening and treatment leads to fewer strokes, heart attacks and deaths.

The programme of research will include a cost-effectiveness analysis to assess whether screening is a good use of NHS resources. Researchers will also observe what goes on in general practices when screening is carried out and interview staff and patients to explore issues around consent to screening and patient concerns.

The UK National Screening Committee has welcomed this trial of systematic population screening for AF. Prof Robert Steele, Independent Chair of the UK National Screening Committee, and Prof Anne Mackie, Director of Screening at Public Health England, said: “Screening for atrial fibrillation, which is a major cause of morbidity and death, would seem to be an excellent idea, but it is only by robust research coupled with economic analysis can we be sure that the benefit of screening outweighs any harm that it may cause and that it is cost-effective."

Further information about this programme can be found here.

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