Detecting AF and enhancing monitoring in partnership with Pharmacists - training session
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The document outlines a pilot project focusing on atrial fibrillation (AF) detection and management involving various health professionals and community pharmacists. It describes two devices, mydiagnostick and AliveCor Kardia, designed for self-testing and monitoring AF, highlighting their functionalities and usage protocols. Additionally, it details the objectives, measures, and data sources for evaluating the project’s outcomes related to AF detection and patient management.
Detecting AF and enhancing monitoring in partnership with Pharmacists - training session
- 1. Hello and welcome Please help yourself to food and refreshment.
- 2. Pharmacy-AF Pilot Project Working group members • NWC Innovation agency Project Manager, Associate Director Patient Safety: Dr Julia Reynolds • GP CVD Clinical Lead, Knowsley CCG: Dr Adit Jain • Joint Chief Officer Halton, St Helens & Knowsley Local Pharmaceutical Committee: Mrs Louise Gatley & Mrs Helen Murphy • Senior Clinical Pharmacist & Chair of Pharmacy Local Professional Network NHS England: Mr Hassan Argomandkhah • GP Pharmacist, Knowsley: Ms Jayne Brady • NWC Innovation agency Project Manager, Patient Safety: Mrs Helen Beaumont-Kellner • NWC Innovation agency, Quality Improvement Lead, Patient Safety: Michelle Coleiro • Liverpool John Moores University, Readers: Dr Lisa Jones and Dr Hannah Timpson
- 3. Pharmacy-AF Pilot Stakeholders Community and GP pharmacist Joint working Community & pathways Community pharmacists GP practice Pharmacist PharmOutcomes Knowsley CCG Halton CCG CCG, CVD groups Stroke prevention Detect & Protect NWC Innovation Agency New ways of workingEffective communication AF Collaborative Alivecor Kardia LJMU LPC/ LPN Pharmacy Patient monitoring & connected health MyDiag nostick 21/11/2019 Helen Beaumont-Kellner RN, BSc (hons), MClin Res 3 Happy Hearts
- 4. Clinical AF Training Dr Phil Jennings, Medical Director @DrPhilJennings
- 5. Anatomy Normal Electrophysiology AF Electrophysiology Clinical consequences Diagnosis Prevalence Treatment
- 11. E P I D E M I O L O G Y AF Prevalence in Age Bands
- 12. E P I D E M I O L O G Y - 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 Missing Patients 2015-16 QOF Expected Prevalence – Number on QOF Register
- 14. Questions?
- 15. David Dewhurst – Patient & Public Involvement Officer @InnovationNWC
- 16. @InnovationNWC
- 17. @InnovationNWC The Diagnostick is the device that will be installed for AF self-testing in the pharmacy setting. This is a class IIa medical device designed in close collaboration with medical professionals to rapidly and effectively detect AF with 96% accuracy according to current research. This device is designed to be straight forward to use and understand. It shows pulse rate through a simple flashing LED and gives a straight forward result. The devices will also be installed on a stand with an information/advice display to help members of the public perform the self-testing. The device is simply held (like bicycle handlebars) for 60 seconds and gives one of 2 results, shown on the next screen. This device may be less suitable for individuals with grip-strength issues as it requires steady contact for the full 60 seconds and may not be able to complete a check if individuals are unable to maintain steady grip for that long.
- 18. @InnovationNWC Hold here And here Lights will progress along here. This takes 60 seconds. No issues detected Possible AF or other irregularity detected. Follow previous advice and issue letter.
- 19. No further action needed. Individual’s result will be double checked with a second ECG device as part of a one to one consultation.
- 20. @InnovationNWC
- 21. Helen will now take us through the software used to pull use data from the MyDiagnostic device and how to send this data to the GP.
- 22. @InnovationNWC
- 23. @InnovationNWC The second device that will be used to check for AF is the AliveCor Kardia, the specific model we use is the KardiaMobile. The AliveCor links to a mobile device through an APP, which you may have already installed on your tablets/phones. We recommend using an NHS email address to register your account. The APP can be found in the Google Play Store or iTunes Store, if you have not already done so. The AliveCor uses the screen of the mobile device to display the ECG trace as it collects data, which can be emailed directly from the device using the email address which you registered to the account. The device will then give one of 3 results:
- 24. @InnovationNWC • Normal AF has not been detected at this time. • Unclassified/Tachycardia/Bradycardia The ‘Unclassified’ result will most often occur due to a break in contact with the device during the test but can also be caused by excessively dry skin or other issue limiting contact/conductivity. Tachycardia/Bradycardia should be treated in line with the pathway for these conditions. • Possible Atrial Fibrillation If the device indicates Possible Atrial Fibrilation, the individual’s data should be entered into the system and sent to their GP along with a copy of their ECG trace for further investigation. Those the KardiaMobile is an accurate device, it should not be used alone as the basis of a diagnosis.
- 25. @InnovationNWC
- 26. Pharmacy Pathway Hassan Argomandkhah, Pharmacy LPN Chair (Merseyside), NHS England
- 27. 21/11/2019 Helen Beaumont-Kellner RN, BSc (hons), MClin Res 27
- 29. Break
- 30. Project Measures Michelle Coleiro, Improvement Lead, Innovation Agency
- 31. Pharmacy-AF: Outcomes & measures Outcomes/objectives Measure Data Source Who? Frequency Test the role of Community Pharmacists in detecting AF No of MyDiagnostick tests completed MyDiagnostick download Comm Pharm 3 monthly No Kardia traces done PharmOutcomes Comm Pharm 1 monthly No ‘possible AF’ Kardia traces PharmOutcomes Comm Pharm 1 monthly Patients with confirmed AF signposted to the Community Pharmacy EMIS search Clin Pharm 1 monthly Test the role of Community Pharmacists in the management of newly diagnosed AF patients No patients consented onto the pilot project PharmOutcomes Comm Pharm 1 monthly No visits to the pharmacy per patient PharmOutcomes Comm Pharm 1 monthly No of pharmacy services signposted to e.g. smoking cessation PharmOutcomes Comm Pharm 1 monthly No of patients engaged with text messaging PharmOutcomes Comm Pharm 1 monthly Patient compliance: Q1: Is patient compliance good? If no, Q2: Cause of poor compliance Q3: Action taken to improve compliance PharmOutcomes Comm Pharm 1 monthly Patient feedback: Q1 Are you finding this service helpful? (1-5) Q2: What other additional support do you suggest? PharmOutcomes Comm Pharm (plus external) 1 monthly Test joint working practices between Community and Clinical Pharmacists Community Pharmacist and Clinical Pharmacist feedback Qualitative interview External 12 and 24 months
- 32. PharmOutcomes and payments Louise Gatley, Joint Chief Officer Halton, St Helens & Knowsley LPC