Podiatry Department, County Durham and Darlington NHS Foundation Trust, Durham, UK.
Academic Health Science Network North East and North Cumbria (AHSN), Biomedical Research Building, Campus for Ageing and Vitality, Newcastle, UK.
Open Heart. 2019 Feb 6;6(1):e000795. doi: 10.1136/openhrt-2018-000795. eCollection 2019.
To determine whether training podiatrists to provide opportunistic screening for atrial fibrillation (AF) during the local diabetes foot check was feasible and whether it detects previously unknown AF.
During the initiative, 45 podiatrists from across North Durham, Darlington and Durham Dales Easington and Sedgefield Clinical Commissioning Groups were trained to recognise heart irregularities when taking pulse readings of feet of patients with diabetes during their annual foot screening reviews.
Over the course of the 3-month pilot, 5000 patients with diabetes had their feet pulse-tested. The project uncovered that for every 500 patients who had their feet checked, one new case of AF could be identified.
A report following the Podiatry and Atrial Fibrillation Case Finding scheme revealed that the National Health Service in the United Kingdom North East and North Cumbria area could benefit from potential cost savings in excess of £500 000. In 2013, the National Diabetes Information Service, Yorkshire and Humber Public Health Observatory estimated 231 777 people in the North East, North Cumbria, Hambleton and Richmondshire area with diabetes. Therefore 463 patients could be found with AF, preventing 23 strokes and saving £539 742 or in excess of £0.5 M.
确定培训足病医生在进行足部糖尿病检查时进行机会性心房颤动(AF)筛查是否可行,以及这种方法是否能检测到先前未知的 AF。
在该计划中,来自北达勒姆、达灵顿和达勒姆戴尔埃辛顿和塞奇菲尔德临床委托组的 45 名足病医生接受了培训,以便在对糖尿病患者的年度足部筛查复查中测量足部脉搏时识别出心脏不规则。
在为期 3 个月的试点期间,5000 名糖尿病患者接受了足部脉搏测试。该项目发现,每检查 500 名患者,就可能发现一例新的 AF 病例。
一项针对足病学和心房颤动病例发现计划的报告显示,英国东北地区和北坎布里亚地区的国民保健制度可能会从超过 50 万英镑的潜在成本节约中受益。2013 年,约克郡和亨伯公共卫生观测站的国家糖尿病信息服务估计,东北地区、北坎布里亚、汉伯勒和里士满郡地区有 231777 名糖尿病患者。因此,可能会发现 463 名 AF 患者,预防 23 次中风,节省 539742 英镑或超过 500 万英镑。