Community pharmacists are ideally placed to support people with AF by:

• Answering the patient’s questions about anticoagulation medication such as:
  • “Why does my blood need thinning if the problem is that my heartbeat is irregular?”
  • “Does it matter if I sometimes forget to take my anticoagulant? Should I take double the amount the next day?”
  • “What are the side-effects?”
• Educating patients by making them aware of the benefits of anticoagulation and supporting adherence at every opportunity
• Making sure the patient has an anticoagulation alert card and carries this with them at all times
• Ensuring patients are aware of possible adverse effects of anticoagulation and what to do if they occur
• Offering services such as the NMS to support medicine adherence
• Identifying patients with AF who are not prescribed anticoagulation and, if at increased stroke risk, referring them back to their GP
• Supplying patient literature on AF or signposting patients to further resources (e.g. the AF Association, the Stroke Association or the British Heart Foundation websites)
• Signposting patients with an irregular pulse to their GP
• Checking for symptoms of AF and where necessary referring back to the GP.

Conclusion

Atrial fibrillation is a common arrhythmia and carries significant mortality and morbidity, mainly related to strokes. Anticoagulation is a key intervention and community pharmacists can help ensure safer anticoagulation for their patients.

Further resources:

• AF Association (charity)
  
• British Heart Foundation 
  
• Heart Research UK.