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.
- 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