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Public Health England and Faculty of Public Health Award for contributions to public health

Public Health England and Faculty of Public Health Award for contributions to public health

Winner: Monica Fisk, Nick Tuck and Sara Vautier, Joint lead community podiatrists, Guy’s and St Thomas’ NHS Foundation Trust

Testing patients during podiatry appointments can lead to increased detection and improved treatment. The use of Kardia mobile ECG devices to carry out pulse checks for AF in community podiatry was piloted between April and September 2018 across the London Boroughs of Southwark and Lambeth. Statistics predict that across these two London boroughs there are over 3,700 people going undetected and may not be receiving the treatment they require. as AF is the leading cause of cardiac arrhythmia and is a major risk factor for ischaemic stroke. 1 in 5 strokes relate to AF.  More than 420,000 people throughout England are unaware they have irregular heart rhythms and of the dangers that this can pose to their health.

By providing opportunistic testing of patients using a mobile ECG device during  routine podiatry appointments, it was predicted that detection rates could be increased in the local population. During the pilot study 376 patients were tested and 16 patients with unknown history of AF were detected, higher than was originally predicted.

Pulse checks using Kardia devices can be completed in 30 seconds and can easily be carried out by a podiatrist or Assistant Practitioner (Podiatry). This relates to PHE priorities of making every contact count by carrying out proactive work to prevent illness and ill health.

The European Primary Care Cardiovascular Society recommend opportunistic case finding in all people 65 years and over. AF is responsible for approximately 20% of all strokes which costs the NHS 2.2 billion each year. Early detection of AF can help prevent Stroke and prevent people from living with the disabling consequences.

Mobile ECG devices cost less than £100 per device and link easily with most smart phones. This project could be easily scaled up and performed in podiatry clinics across the country with minimal time and cost output.

This project was supported by the Health Innovation Network through assistance in monitoring detection rates and patient numbers, and local GPs through awareness of the project and onward referral for further testing.

 

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