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Headline

GPs set for incentives to screen for atrial fibrillation

Comment

(1) We all can agree that checking the pulse alongside BP is natural in an physical examination in any age group . Question is how often should we check on patients , especially those asymptomatic with no registered chronic illnesses. That refers to the principle of screening . Every 5 years , every 3 years? Perhaps , that really needs some statistics to support some arguments. But we also know there is something called interval incidents , just like in breast , cervical , bowel and AAA screening . A selected age group e.g. 65 makes sense. (2) The ball does not stop at the point of picking up the irregularly irregular pulse . It leads to verification of the diagnosis,subsequent oral anticoagulant and the actual counselling of which one to use(as well as options of treating AF). It should be quite a proactive , dynamic sequence of actions.One can argue a community one stop shop for GPs to refer after picking up AF is one way but it depends on waiting time . I would argue patients prefer to be followed up by the same clinician(or the colleagues in same practice, hence not for locums working short period of time here and there). Clearly , it demonstrates the essential role of general practitioners from palpating the pulse to commencing oral anticoagulants in a fashion of continuity .(Yes , yes , not the cup of tea for those arguing fast and easy GP access!) (3) Overall , we are dealing with both secondary prevention of AF and more importantly primary prevention of systemic embolisation and hence , stroke . If the health stakeholders genuinely understand this health philosophy and science , fund (including funding to train) General Practice 'properly' in a package as I am not sure several QOF points are really up to it.

Posted date

03 Aug 2016

Posted time

4:34pm

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