Screening of atrial fibrillation in dental practices: a qualitative feasibility study

To increase the detection of unknown atrial fibrillation (AF), general practitioners have started screening their patients using small hand-held devices. It is thought that dental settings could be utilized for screening as they have regular access to patients. The aim of this study was to explore the perceptions of dental staff of screening for AF using a hand-held electronic device in primary dental care. The research took place in one large mixed NHS and private general dental practice. Views from staff including dentists, dental therapists, dental nurses, and managers were elicited via semi-structured interviews conducted face-to-face, audio recorded, and transcribed verbatim. Interviews continued until there were no new themes or patterns emerging from the data, and thematic saturation had been achieved. Eleven participants were interviewed. The main themes generated were methodology for screening, acceptability for screening within the practice, attitudes to screening, and implementation of screening. Overall, participants were positive about implementing AF screening in a dental practice but expressed concerns about time and remuneration. Staff also gave encouraging feedback regarding the simplicity of the portable screening device. Participants felt that AF screening in primary care dental practices was a good concept but may be challenging to implement in NHS Dentistry, especially due to the pandemic.

为提升对未知心房颤动（atrial fibrillation, AF）的检出率，全科医生已开始借助小型手持设备对患者开展筛查。鉴于牙科诊疗场景可稳定接触患者群体，学界认为其可被用于AF筛查工作。本研究旨在探究牙科医护人员对基层牙科诊疗场景中使用手持电子设备开展AF筛查的认知态度。本次研究在一家兼具英国国民保健制度（NHS）与私人诊疗业务的大型综合牙科诊所开展。研究通过面对面半结构化访谈收集了牙医、牙科治疗师、牙科护士及管理人员等各类牙科医护人员的观点，访谈全程录音并逐字转录。访谈持续至数据中不再出现新的主题与模式，达到主题饱和为止，最终共有11名参与者接受访谈。本次研究提炼出四大核心主题：筛查实施方法、诊所内筛查接受度、筛查相关态度，以及筛查落地执行。整体而言，参与者对在牙科诊所开展AF筛查持积极态度，但同时也表达了对时间成本与薪酬报酬的担忧。医护人员还对这款便携筛查设备的操作简便性给出了积极反馈。参与者认为，基层牙科诊所开展AF筛查是一项颇具价值的理念，但在英国国民保健制度牙科体系内落地可能存在难度，新冠疫情更是加剧了这一挑战。