None listed
Conditions
Brief summary
Background: The leading cause of death for Aboriginal Australians is cardiovascular disease, including stroke and heart attack. Atrial Fibrillation is a precursor to stroke. There are no published studies about the prevalence of Atrial Fibrillation for Aboriginal people. The purpose of the study is twofold: to estimate prevalence of Atrial Fibrillation in Australian Aboriginal people and evaluate the effectiveness of opportunistic screening, and assessment and treatment pathways for Aboriginal people with Atrial Fibrillation or other arrhythmias. Methods: This is a mixed methods study which will screen 1500 Australian Aboriginal people living in New South Wales, Northern Territory or Western Australia to estimate prevalence of Atrial Fibrillation. This data will be analysed statistically to estimate prevalence. In addition, the study will conduct semi-structured interviews with Aboriginal workers who conduct the screens to evaluate qualitatively the effectiveness of opportunistic screening using an iECG to facilitate timely assessment and treatment for Aboriginal people over 45 years. Discussion: The study aims to determine the feasibility of the portable iECG device to diagnose abnormal heart rhythm in Aboriginal people and facilitate access to further assessment and treatment; estimate the prevalence of AF in Aboriginal people in Australia; improve health literacy in Aboriginal people and health workers; and help prevent the effects of untreated AF in Aboriginal people; including ischemic stroke and prevent early deaths or impairment.
Interventions
Opportunistic screening of Aboriginal people over 45 years using a portable ECG attached to a smart phone.
1. The screening will be undertaken by local Aboriginal health workers supervised by a Registered Nurse.
2. All health workers (known as screeners in the study) will receive one day of training of face to face training.
3. They will receive daily support from a Registered Nurse. All screeners will report patients with a non-normal result for follow up by the Registered Nurse.
4. All
Opportunistic screening of Aboriginal people over 45 years using a portable ECG attached to a smart phone. 1. The screening will be undertaken by local Aboriginal health workers supervised by a Registered Nurse. 2. All health workers (known as screeners in the study) will receive one day of training of face to face training. 3. They will receive daily support from a Registered Nurse. All screeners will report patients with a non-normal result for follow up by the Registered Nurse. 4. All participants will be formally consented into the study by a local Aboriginal person and receive health literacy information as well as a participant information sheet. The health literacy will be in the form of a printed sheet in plain English and pictorial form. We are seeking advice of Aborignal health literacy experts in design, and the content will be approved by cardiologist Prof Ben Freedman. This resource is expected to be drafted for review by mid-April. 5. The screening will occur in the usual course of the workers duties in the Aboriginal Health Service, health clinic, pharmacy, home visit or community centre. 6. The screeners will undertake a 30 second screen by asking the patient to hold onto a small probe attached to a smart phone. The process is painless and quick, and a result appears on the smart phone App. 7. There are three possible results: normal; Atrial Fibrillation; or unreadable. 8. Anyone screened with result other than Normal will be referred for a 12-lead ECG to confirm the diagnosis and plan further assessment and treatment as indicated. 9. Each eligible patient will be screened once. Each screener will undertake 50 screens with eligible patients. There are 30 screeners in the study and each screener is supervised and supported by a Registered Nurse. 10. The host organisation will retain the device for use in their practice once the 50 screens have been included in the study. 11. Host organisations each have an investigator on the study and several members of the Investigators team are Aboriginal. 12. The Principal Investigator will have weekly teleconferences with the Registered Nurses about progress and issues.
Sponsors
Poche Centre for Indigenous Health, The University of Sydney
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Diagnosis
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
45 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Aboriginality; aged 45 years or over; Australian
Exclusion criteria
non-Aboriginal people; people under 45 years
Outcome results
None listed