Background: Atrial fibrillation (AF) accounts for up to one third of strokes, one of the lead mortality causes worldwide. The European Society of Cardiology guidelines recommend opportunistic screening as a means to increase the odds of early detection and institution of appropriate treatment according to risk factors identified. However, in most countries there are various barriers to effective uptake of screening, including low awareness. The Atrial Fibrillation Association is a patient association engaged with raising awareness of AF. Establishing a partnership with the International Pharmacists for Anticoagulation Care Taskforce, we set as goals to test a model for raising awareness of AF involving pharmacists globally; and to identify barriers and enablers to its implementation. Methods: A cross-sectional study was conducted during the Arrhythmia Alliance World Heart Rhythm Week. Pharmacists from 10 countries invited individuals (≥40 years; without anticoagulation therapy of AF) to participate in the awareness campaign.Participants agreeing were engaged in the early detection of AF (EDAF) using pulse palpation. Individuals with rhythm discrepancies were referred and prospectively assessed to have information on the proportion of confirmed diagnosis, leading to estimate the detection rate. Interviews with country coordinators explored barriers and enablers to implementation.Results: The study involved 4,193 participants in the awareness campaign and 2,762 in the EDAF event (mean age 65.3±13.0), of whom 46.2% individuals were asymptomatic, recruited across 120 sites. Most common CHA2DS2-VASc risk factor was hypertension. 5Among 161 patients referred to physician, feedback was obtained for 32 cases, of whom 12 new arrhythmia diagnoses were confirmed (5 for AF, 2 for atrial flutter), all among elders (≥65 years). Qualitative evaluation suggested a local champion to enable pharmacists' success; technology enhanced engagement amongst patients and increased pharmacists' confidence in referring to physicians; interprofessional relationship was crucial in success. Conclusion:This study suggests involving pharmacists is beneficial for greater outreach of awareness campaigns. Effective communication pathways for inter-professional collaboration are needed to gain full benefits of EDAF.

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May Measurement Month 2017 is a global initiative aimed at raising awareness of high blood pressure (BP) and to act as a temporary solution to the lack of screening programs worldwide, in which Spain participated actively. The primary objective was to raise awareness and increase control of BP in Spain. An opportunistic cross-sectional survey of volunteers aged ≥18 was set up in May 2017. Following the design of the International Society of Hypertension, data were collected from the 17 autonomous communities in which Spain is divided, mainly in community pharmacies, primary care centres and some hypertension (HT) units, and cardiovascular departments in hospitals. No additional training of volunteers was necessary. A total of 3849 individuals were screened. After multiple imputation, our data showed that 1923 (50.0%) had HT. In those not receiving antihypertensive medication, 17.5% were hypertensives, in individuals receiving antihypertensive medication, 33.9% had uncontrolled BP. May Measurement Month 2017 was the largest BP screening campaign undertaken in Spain. In total, 17.5% of people with HT did not receive medication. One-third of hypertensive participants receiving treatment did not have their BP controlled. These results confirm that an opportunistic screening can identify a significant number of subjects with and untreated and inadequately treated BP.

Elevated blood pressure (BP) is the single most important contributing risk factor to the global disease burden, leading to over 10 million deaths each year. In Spain, hypertension (HTN) affects around 20% of the adult population and remains the greatest attributable cause of cardiovascular mortality. May Measurement Month (MMM) is a worldwide initiative aimed at increasing awareness of HTN and to improve the lack of screening programmes worldwide. An opportunistic cross-sectional survey of volunteers aged 18 and over was carried out in May 2018. Blood pressure measurement, the definition of HTN and statistical analysis followed the standard MMM protocol. Anthropometric data and responses to questionnaires on demographic, lifestyle, and environmental factors were obtained as additional information. Screening sites mainly in community pharmacies, universities, primary care centres, HTN units, and cardiovascular departments in hospitals were set up across Spain as part of this initiative. In total, 7646 individuals (63.5% female) were screened during MMM18. After multiple imputation, 40.0% had HTN, of whom 74.4% were aware of their diagnosis and 69.6% were taking antihypertensive medication. Of individuals not receiving antihypertensive medication, 16.9% were hypertensive. Of individuals receiving antihypertensive medication, 36.4% had uncontrolled BP. MMM18 almost doubled the number of participants of MMM17 and was the largest BP screening campaign ever undertaken in Spain, showing that in the absence of systematic screening programmes for HTN, MMM can identify a great number of individuals at risk, increasing their awareness and attracting the interest of the healthcare system in Spain.