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Health care delivery, economics and global health care
Original research article
Empowering podiatrists to perform pulse checks for opportunistic atrial fibrillation detection during annual diabetes foot checks
  1. Linda Hicks1,
  2. Julia Newton2,
  3. Rahul Nayar3 and
  4. Kate Mackay2
  1. 1 Podiatry Department, County Durham and Darlington NHS Foundation Trust, Durham, UK
  2. 2 Academic Health Science Network North East and North Cumbria (AHSN), Biomedical Research Building, Campus for Ageing and Vitality, Newcastle, UK
  3. 3 Northern Diabetes Footcare Network, Northern England Clinical Networks, NHSE and City Hospitals, Sunderland, UK
  1. Correspondence to Dr Julia Newton; julia.newton{at}ncl.ac.uk

Abstract

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.

  • atrial fibrillation
  • diabetes
  • podiatry

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/openhrt-2018-000795

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    Footnotes

    • Contributors All authors contributed to the design of the study and reviewed and approved the final draft. LH performed the training and collated the data. KM and RN had the original idea and wrote the first draft. JN performed the analysis.

    • Funding The project was funded by the Academic Health Science Network NENC.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.