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1 results

  • Cardiac monitoring in memory clinics: national survey of UK practice

  • George Crowther, Noura Ahmed, Deepa Kasa, Zoe Goff, Muzahir H. Tayebjee
  • Journal:
    BJPsych Bulletin / Volume 47 / Issue 1 / February 2023
    Published online by Cambridge University Press:
    26 November 2021, pp. 11-16
    Print publication:
    February 2023
    • Article
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  • Aims and method

    People diagnosed with dementia are often started on acetylcholinesterase inhibitors (AChEIs). As AChEIs can be associated with cardiac side-effects, an electrocardiogram (ECG) is sometimes requested before treatment. Previous work has suggested there is little consensus as to when or how ECGs should be obtained. This can create inconsistent practice, with patient safety, economic and practical repercussions. We surveyed 305 UK memory clinic practitioners about prescribing practice.

    Results

    More than 84% of respondents completed a pulse and cardiac history before prescribing AChEIs. Opinion was divided as to who should fund and conduct ECGs. It was believed that obtaining an ECG causes patients inconvenience and delays treatment. Despite regularly interpreting ECGs, 76% of respondents did not update this clinical skill regularly.

    Clinical implications

    The variation in practice observed has service-level and patient implications and raises potential patient safety concerns. Implementing national guidelines or seeking novel ways of conducting cardiac monitoring could help standardise practice.