Home' Australian Pharmacist : Australian Pharmacist May 2015 Contents Australian Pharmacist May 2015 I ©Pharmaceutical Society of Australia Ltd.
1. Which of the following statements
about AF is INCORRECT?
a) Hypertension is the primary risk factor
b) The prevalence of AF is strongly age
c) People with AF have a five-fold
increased risk of stroke.
d) Permanent AF confers a greater risk of
thromboembolism than paroxysmal AF.
2. Screening for AF:
a) Is relevant because AF is often
b) Is recommended for all individuals ≥
c) Can only be conducted in secondary
3. Which of the following statements
regarding specificity is CORRECT?
a) Screening mechanisms with lower
specificity have a higher risk of false
b) Specificity may be particularly important
when determining the accuracy of
screening for uncommon conditions.
c) The specificity of screening mechanisms
is always lower than the sensitivity.
4. Oscillometric blood pressure
monitors incorporating algorithms
to detect AF may be beneficial for AF
a) They are suitable regular for self-
monitoring, increasing the chance of
detecting paroxysmal AF.
b) They provide an objective assessment
c) Blood pressure monitoring is often
relevant to people at risk of AF.
d) All of the above.
5. Mary (72 years old) presents to
the pharmacy for her ramipril
script. She has recently read a
newspaper article about the growing
prevalence of AF. Although she has
no symptoms, Mary is worried she
might be affected, and asks if you
can test her for AF. Which of the
following statements is CORRECT?
a) Guidelines don’t recommend
opportunistic screening for Mary
because she reports no symptoms of AF.
b) If Mary returns a negative screening
result, you can advise her she doesn’t
c) A positive screening result is sufficient
to diagnosis AF.
d) None of the above.
• AF is the most common sustained
cardiac arrhythmia, and a major cause
• AF is often asymptomatic; therefore
opportunistic screening is important
to ensure early detection and
• Hypertension is the primary risk
factor for stroke; therefore the dual
functionality of blood pressure
machines with AF detection has
obviously clinical benefit for
• Microlife AFib technology is
incorporated into several widely
available BP monitors, and has
received endorsement for clinical
effectiveness and cost efficiency by the
NICE technical Guidance committee.
1. Ball J, Thompson D, Ski C, et al. Estimating the current and
future prevalence of atrial fibrillation in the Australian adult
population. MJA 2015;202(1):32–35.
2. Kearley K, Selwood M, Van den Bruel A, et al. Triage tests for
identifying atrial fibrillation in primary care: a diagnostic
accuracy study comparing single-lead ECG and modified
BP monitors. BMJ Open 2014;4(5):e004565. doi:10.1136/
3. Dewar R, Lip G on behalf of the Guidelines Development
Group for the NICE clinical guideline for the management
of atrial fibrillation. Identification, diagnosis and assessment
of atrial fibrillation. Heart. 2007;93(1):25–28.
4. Kollias A, Stergiou G. Automated measurement of office,
home and ambulatory blood pressure in atrial fibrillation.
Clinical and experimental pharmacology and physiology.
5. Stergiou G, Karpettas N, Protogerou A, et al. Diagnostic
accuracy of a home blood pressure monitor to detect atrial
fibrillation. Journal of human hypertension 2009;23;654–
6. Camm A, Lip G, De Caterina R, et al. 2012 focused upate of
the ESC Guidelines for the management of atrial fibrillation.
Eur Heart J 2012;33:2719–2747.
7. Willis I, Keltie K, Cariag J. WatchBP Home A for
opportunistically detection atrial fibrillation during
diagnosis and monitoring of hypertension: A NICE medical
technology guidance. Appl Health Econ Health Policy
8. Rosenthal L. Atrial Fibrillation. Medscape Reference. 2014.At:
9. Atrial Fibrillation [revised Feb 2012]. In: eTG complete.
Melbourne: Therapeutic Guidelines; 2015. At: http://online.
10. Wiesel J, Fitzig L, Herschman Y et al. Detection of atrial
fibrilattion using a modified microlife blood pressure
monitor. Am J hypertens 2009;22:848–852.
11. National Clinical Guideline Centre. Atrial fibrillation: the
management of atrial fibrillation. Manchester:NICE; 2014..
12. Lowres N, Neubeck L Salkeld G, et al. Feasibility and cost-
effectiveness of stroke prevention through community
pharmacy screening for atrial fibrillation using iPhone
ECG in pharmacies:The SEARCH AF study. Thrombosis and
13. Verberk W, de Leeuw P. Accuracy of oscillometric blood
pressure monitors for the detection of atrial fibrillation: a
systemic review. Expert Rev Med Devices 2012;9(6):635–
14. Chugh S, Havmoeller R, Narayanan K, et al.. Worldwide
epidemiology of atrial fibrillation: A global burden of
disease 2010 study. Circulation. 2014; 129(8):837-847.
15. Fuster V, Rydén L,Cannom E, et al. ACC/AHA/ESC 2006
Guidelines for the management of patients with atrial
fibrillation – Executive summary. J Am Coll Cardiol
16. Meschia J, l Bushnell C, Boden-Albala B, et al on behalf
of the American Heart Association Stroke Council,
Council on Cardiovascular and Stroke. Guidelines for the
Primary Prevention of Stroke: A Statement for Healthcare
Professionals From the AmericanHeart Association/
American Stroke Association. Stroke. 2014;45:3754–3832.
17. Wiesel J, Arbesfeld B, Schechter D. Comparison of the
microlife blood pressure monitors with the Omron blood
pressure monitor for detecting atrial fibrillation. Am J
Cardiol. 2014;114: 1046–1048.
18. Hobbs F, Fitzmaurice D, Jowett S, et al. A randomised
controlled trial and cost-effectiveness study of systematic
screening (targeted and total population screening) versus
routine practice for the detection of atrial fibrillation in
people aged 65 and over: the SAFE study. Health Technol
19. Estes N, Sacco R, Al-Khatib S, et al. American Heart
Association Atrial Fibrillation Research Summit: A
Conference Report From the American Heart Association.
20. Representatives of Omron Europe B.V. Correspondance
re: Comparision of Microlife BP 20 AFIB and Ormon M6
Comfort. 23 October 2014.
21. National Institute for Health and Clinical Excellence
(NICE). WatchBP Home A for opportunistically detecting
atrial fibrillation during diagnosis and monitoring of
hypertension: NICE medical technology guidance 13.
22. Lau J, Loweres N, Neubeck L, et al. iPhone ECG appication
for community screening to detect silent atrial fibrillation:
A Novel technology to prevent stroke. In J Cardiol
23. Alive technologies: AliveCor heart monitor. 2015. At: www.
24. Apple iStore: Alive ECG. 2015. At: https://itunes.apple.com/
25. Krass I, Mitchell B, Clarke P, et al. Pharmacy diabetes
care program: analysis of two screening methods for
undiagnosed type 2 diabetes in Australian Community
Pharmacy. Diabetes Res clin Pract 2007;75:339–347.
26. Baraitser P, Pearce V, Holmes J et al. Chlamydia testing in
community pharmacies: evaluation of a feasibility pilot in
south east London. Qual Saf Health Care 2007;16:303–307.
Answer online at www.psa.org.au
Links Archive Australian Pharmacist April 2015 Australian Pharmacist June 2015 Navigation Previous Page Next Page