Primary Care and Population Sciences, University of Southampton, Southampton, UK
Primary Care and Population Sciences, University of Southampton, Southampton, UK.
BMJ Open. 2020 Mar 18;10(3):e033061. doi: 10.1136/bmjopen-2019-033061.
There has been increased interest in screening for atrial fibrillation (AF) with commissioned pilot schemes, ongoing large clinical trials and the emergence of inexpensive consumer single-lead ECG devices that can be used to detect AF. This qualitative study aimed to explore patients' views and understanding of AF and AF screening to determine acceptability and inform future recommendations.
A single primary care practice in Hampshire, UK.
15 participants (11 female) were interviewed from primary care who had taken part in an AF screening trial. A semistructured interview guide was used flexibly to enable the interviewer to explore any relevant topics raised by the participants. Interviews were recorded, transcribed verbatim and analysed using inductive thematic analysis.
Participants generally had an incomplete understanding of AF and conflated it with other heart problems or with raised blood pressure. With regards to potential drawbacks from screening, some participants considered anxiety and the cost of implementation, but none acknowledged potential harms associated with screening such as side effects of anticoagulation treatment or the risk of further investigations. The screening was generally well accepted, and participants were generally in favour of engaging with prolonged screening.
Our study highlights that there may be poor understanding (of both the nature of AF and potential negatives of screening) among patients who have been screened for AF. Further work is required to determine if resources including decision aids can address this important knowledge gap and improve clinical informed consent for AF screening.
ISRCTN 17495003.
随着委托试点计划、正在进行的大型临床试验以及价格低廉的消费者单导联心电图设备的出现，人们对心房颤动（AF）筛查的兴趣日益增加，这些设备可用于检测 AF。本定性研究旨在探讨患者对 AF 和 AF 筛查的看法和理解，以确定其可接受性并为未来的建议提供信息。
英国汉普郡的一家基层医疗诊所。
从参加 AF 筛查试验的基层医疗中采访了 15 名参与者（11 名女性）。使用半结构化访谈指南灵活地进行访谈，以使访谈者能够探讨参与者提出的任何相关主题。访谈进行了录音、逐字转录，并使用归纳主题分析进行了分析。
参与者通常对 AF 的理解不完整，并将其与其他心脏问题或高血压混淆。关于筛查的潜在缺点，一些参与者考虑到焦虑和实施成本，但没有人承认与筛查相关的潜在危害，例如抗凝治疗的副作用或进一步调查的风险。筛查总体上得到了很好的接受，参与者普遍赞成进行长期筛查。
我们的研究表明，接受 AF 筛查的患者对 AF 的性质和筛查的潜在负面影响可能理解不足。需要进一步研究确定资源（包括决策辅助工具）是否可以解决这一重要的知识差距，并改善 AF 筛查的临床知情同意。
ISRCTN 17495003。
