Screening auf Vorhofflimmern durch Podologen

Hicks L et al.: Empowering podiatrists to perform pulse checks for opportunistic atrial fibrillation detection during annual diabetes foot checks. Open Heart (2019) 6(1):e000795.
doi: 10.1136/openhrt-2018-000795
Initiative in Großbritannien. 45 Podologen haben im Jahr 2016 innerhalb von drei Monaten den Puls ihrer Patienten beim jährlichen Routine-Check mittels Doppler analysiert und bei Verdacht auf Vorhofflimmern zum Hausarzt weitergeleitet. Bei 10/5.000 (0.2 %) Patienten wurde auf diesem Weg zuvor unbekanntes Vorhofflimmern diagnostiziert.

OBJECTIVE:
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.
METHOD:
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.
RESULTS:
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.
CONCLUSION:
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.

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