Pharmacy-Based Atrial Fibrillation Screening Model Coordinated by a Regional Stroke and Cardiovascular Disease Support Center　― The Catch AF Project ―

Abstract

Background: Atrial fibrillation (AF) is a major cause of cardioembolic stroke and often remains undiagnosed because of its asymptomatic or paroxysmal nature. Although opportunistic AF screening has been advocated, sustainable community-based screening models that link the results to medical evaluations are limited. We implemented a pharmacy-based AF screening initiative (Catch AF project) led by a regional Stroke and Cardiovascular Disease Support Center with community pharmacists and physicians to assess its feasibility and follow-up outcomes.

Methods and Results: The Catch AF project was conducted at 34 community pharmacies in Nagasaki, Japan. A single-lead electrocardiogram (ECG) device with automated analysis was installed to offer opportunistic screening for pharmacy visitors. Of the 5,371 ECG recordings, 123 (2.29%) indicated possible AF. Pharmacists recommended medical consultation for 60 individuals (49% of the detected cases). Questionnaire surveys demonstrated that stakeholders generally perceived the initiative as acceptable and feasible. In contrast, only a small number of physicians reported encounters with referred patients, indicating a marked gap between AF detection through pharmacy-based screening and subsequent medical evaluation.

Conclusions: A center-led pharmacy-based AF screening initiative is feasible and well accepted in a real-world setting. However, a substantial gap between screening detection and clinical follow up highlights the need for improved referral pathways and coordination between pharmacies and medical institutions to enhance the effectiveness of community-based screening programs.