Impact of abnormal ambulatory ECG findings when screening for atrial fibrillation in primary care: a qualitative study among participants of the PATCH-AF trial
Background and aim European cardiovascular guidelines recommend systematic atrial fibrillation (AF) screening in community-dwelling high-risk patients. However, little is known about the impact of abnormal screening findings, including AF and non-AF incidental findings on the target population. This...
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BMJ Publishing Group
2025-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/7/e102160.full |
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| author | Ralf E Harskamp Jelle C L Himmelreich Eric P Moll van Charante Tessa Brik Marilou S Niekel Marieke A R Bak |
| author_facet | Ralf E Harskamp Jelle C L Himmelreich Eric P Moll van Charante Tessa Brik Marilou S Niekel Marieke A R Bak |
| author_sort | Ralf E Harskamp |
| collection | DOAJ |
| description | Background and aim European cardiovascular guidelines recommend systematic atrial fibrillation (AF) screening in community-dwelling high-risk patients. However, little is known about the impact of abnormal screening findings, including AF and non-AF incidental findings on the target population. This gap highlights the need to assess both the benefits and potential harms from patients’ perspectives to fully understand the impact of AF screening. Therefore, the aim of this study is to explore patients’ experiences with AF screening among those who received abnormal findings from ambulatory ECG monitoring.Design We conducted a qualitative study using semistructured interviews, analysed thematically. Participants in the PATCH-AF trial, based in Amsterdam primary care, were purposively sampled based on their screening results (AF or non-AF incidental findings), sex and socioeconomic status.Results We achieved data saturation after conducting 16 interviews (6 with interviewees diagnosed with AF and 10 with non-AF incidental findings). Participants had a median age of 76 (73–79) years, and 56% were male. Their experiences, whether positive or negative, fluctuated throughout the screening process and depended on their initial motivations for participation in AF screening (seeking extra health checks, finding explanations for pre-existing symptoms or contributing to medical research), expectations and perceived benefits from clarification, diagnostic workup or treatment. Influencing factors included the type of finding (AF or non-AF incidental finding), healthcare provider communication and individual characteristics such as age, socioeconomic status and medical history.Conclusion This qualitative study highlights both positive and negative AF screening experiences from the patients’ perspective. It underscores how patients’ motivations and expectations for participation, the type of ambulatory ECG finding and communication and follow-up by healthcare providers shape their overall experiences. Healthcare providers should be aware of these factors to optimise screening consultations. Clear guidelines on communicating abnormal ambulatory ECG findings, especially incidental findings, are warranted.Trial registeration number The Netherlands Trial Register (NTR) number NL9656. |
| format | Article |
| id | doaj-art-bce0927a24c44f43a29e4a57e7a88f4e |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-bce0927a24c44f43a29e4a57e7a88f4e2025-08-20T03:55:49ZengBMJ Publishing GroupBMJ Open2044-60552025-07-0115710.1136/bmjopen-2025-102160Impact of abnormal ambulatory ECG findings when screening for atrial fibrillation in primary care: a qualitative study among participants of the PATCH-AF trialRalf E Harskamp0Jelle C L Himmelreich1Eric P Moll van Charante2Tessa Brik3Marilou S Niekel4Marieke A R Bak5Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, The NetherlandsDepartment of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, The NetherlandsDepartment of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, The NetherlandsDepartment of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, The NetherlandsDepartment of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, The NetherlandsDepartment of Ethics, Law and Humanities, Amsterdam UMC, University of Amsterdam, Amsterdam, The NetherlandsBackground and aim European cardiovascular guidelines recommend systematic atrial fibrillation (AF) screening in community-dwelling high-risk patients. However, little is known about the impact of abnormal screening findings, including AF and non-AF incidental findings on the target population. This gap highlights the need to assess both the benefits and potential harms from patients’ perspectives to fully understand the impact of AF screening. Therefore, the aim of this study is to explore patients’ experiences with AF screening among those who received abnormal findings from ambulatory ECG monitoring.Design We conducted a qualitative study using semistructured interviews, analysed thematically. Participants in the PATCH-AF trial, based in Amsterdam primary care, were purposively sampled based on their screening results (AF or non-AF incidental findings), sex and socioeconomic status.Results We achieved data saturation after conducting 16 interviews (6 with interviewees diagnosed with AF and 10 with non-AF incidental findings). Participants had a median age of 76 (73–79) years, and 56% were male. Their experiences, whether positive or negative, fluctuated throughout the screening process and depended on their initial motivations for participation in AF screening (seeking extra health checks, finding explanations for pre-existing symptoms or contributing to medical research), expectations and perceived benefits from clarification, diagnostic workup or treatment. Influencing factors included the type of finding (AF or non-AF incidental finding), healthcare provider communication and individual characteristics such as age, socioeconomic status and medical history.Conclusion This qualitative study highlights both positive and negative AF screening experiences from the patients’ perspective. It underscores how patients’ motivations and expectations for participation, the type of ambulatory ECG finding and communication and follow-up by healthcare providers shape their overall experiences. Healthcare providers should be aware of these factors to optimise screening consultations. Clear guidelines on communicating abnormal ambulatory ECG findings, especially incidental findings, are warranted.Trial registeration number The Netherlands Trial Register (NTR) number NL9656.https://bmjopen.bmj.com/content/15/7/e102160.full |
| spellingShingle | Ralf E Harskamp Jelle C L Himmelreich Eric P Moll van Charante Tessa Brik Marilou S Niekel Marieke A R Bak Impact of abnormal ambulatory ECG findings when screening for atrial fibrillation in primary care: a qualitative study among participants of the PATCH-AF trial BMJ Open |
| title | Impact of abnormal ambulatory ECG findings when screening for atrial fibrillation in primary care: a qualitative study among participants of the PATCH-AF trial |
| title_full | Impact of abnormal ambulatory ECG findings when screening for atrial fibrillation in primary care: a qualitative study among participants of the PATCH-AF trial |
| title_fullStr | Impact of abnormal ambulatory ECG findings when screening for atrial fibrillation in primary care: a qualitative study among participants of the PATCH-AF trial |
| title_full_unstemmed | Impact of abnormal ambulatory ECG findings when screening for atrial fibrillation in primary care: a qualitative study among participants of the PATCH-AF trial |
| title_short | Impact of abnormal ambulatory ECG findings when screening for atrial fibrillation in primary care: a qualitative study among participants of the PATCH-AF trial |
| title_sort | impact of abnormal ambulatory ecg findings when screening for atrial fibrillation in primary care a qualitative study among participants of the patch af trial |
| url | https://bmjopen.bmj.com/content/15/7/e102160.full |
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