The information below relates to the CVD prevention pathway.

• Undertake systematic audit across practices (GRASP-AF audit tool and the Warfarin Patient Safety Tool).
  • Identify people with possible undiagnosed AF.
  • Identify people with AF at high risk of stroke who are not anticoagulated or not maintained in the therapeutic range.
• Work with practices and local authorities to maximise NHS Health Check uptake and follow up.
• Build local primary care leadership to challenge unwarranted variation and drive quality improvement in detection and management.
• Add pulse checking to existing GP and pharmacy enhanced services for people over 65.
• Agree local clinical consensus and pathway for anticoagulation including the place of novel oral anticoagulants (NOACs).
• Consider commissioning:
  • Technologies such as WatchBP Home A and AliveCor to support AF detection in routine care.
  • New models of anticoagulation control eg self-monitoring and community pharmacy monitoring
  • Systematic support for adherence from community pharmacists.

Further information

• NICE pathway on managing atrial fibrillation
• WatchBP Home A appraisal
• AliveCor Heart Monitor and AliveECG app for detecting atrial fibrillation
• Case study 1: BHF Management of AF in primary care: The NHS Lanarkshire experience
• Case study 2: BHF Managing AF in primary care: Key issues for primary care practitioners, managers and commissioners of services
• Case study 3: PCCJ: Improving anticoagulation in patients with atrial fibrillation

Return to the CVD prevention pathway.