12,600 people will help test screening for a common heart condition which is known to be a trigger for strokes.
A large new programme of health research on screening for undiagnosed atrial fibrillation, the heart condition responsible for one in ten strokes, is starting here in East Anglia, the North West, the East Midlands and the South West of England.
The research has been designed so that it can continue safely during the COVID pandemic. It will involve around 12,600 people aged 70 or over over the next few months, before being scaled up later this year. Ultimately, the research team will need 126,000 people across the country to take part.
The £3m trial is funded by the National Institute for Health Research (NIHR), the country’s largest funder of health research.
The research, called the SAFER trial, is important because atrial fibrillation, or AF, is a common heart problem, especially for people over 70. Many people do not know they have it, but the condition is linked to increased risks of serious problems like stroke, heart attack and dementia.
About 10% of strokes, for example, happen in people unaware that they have atrial fibrillation. Once diagnosed, AF can be treated, so the risks of more serious problems can be reduced.
Professor Jonathan Mant, lead researcher on the SAFER trial at the University of Cambridge, explained: “Anticoagulation therapy is a very effective treatment that can reduce the risk of stroke by about 65%, so many of these strokes are preventable. The SAFER trial will investigate whether screening for AF is effective and cost efficient.”
“To get clear results, we’ll need 126,000 people to be part of this research and to achieve that, we estimate we’ll need to invite over 400,000 people.”
It’s a landmark trial that will help the NHS decide whether to start a national screening programme for atrial fibrillation.”
– Jonathan Mant, Professor of Primary Care Research, University of Cambridge
12,600 people aged 70 and over, who are more likely than younger people to have AF, are needed in East Anglia, the North West, the East Midlands and the South West of England this spring. Eligible people will be contacted by their GP practice in this area and invited to join the trial.
In the SAFER trial, all the screening will be done remotely, at home, via a small hand-held electronic device, Zenicor-ECG. The device takes readings of the heart’s rhythm and sends the data to the researchers automatically. It is “incredibly simple”, according to Mrs Julia Fox, 75, who trialled the device at the end of 2020.
Mrs Fox explained: “We watched the little video showing you how to use it and I thought, I’m sure I can cope with that. And it really is incredibly simple. You just put your thumbs on the little buttons and then it tells you when to press send. Then off the information goes, and that’s it. We even took it on walks.”
“You don’t have to think to yourself, I have to be at home. It was so easy it was unbelievable. On the days I was at home, I put stickies in the kitchen to make sure I used it, so I’d remember.”
It’s a great satisfaction to me that I might have contributed to helping diagnose AF at a point when it could be better treated”
– Mrs Julia Fox, participant in this research
Dr Helen Macdonald, Chief Operating Officer for the NIHR’s Clinical Research Network Eastern, said “This research could have a huge impact on reducing many patients’ risk of stroke. It is crucial that we are able to continue running important trials such as this, despite challenges caused by the pandemic. The trial can’t happen without the involvement of people like Mrs Fox and all those who participate, and we are incredibly grateful for their generous and vital input.”
Learn more from the SAFER trial website
Find out more about getting involved in other health research: visit bepartofresearch.uk
Contact and interview requests: Lucy Lloyd
About Mrs Julia Fox
Julia Fox and her husband moved to Aldeburgh on the Suffolk coast in 2009. Julia, now 75, still sometimes misses the bright lights of London but she loves the seaside and heathland walks and her garden. Julia used to work as an administrator making it all happen in influential London think tanks and she still uses her shorthand sometimes to keep track of things. She says: ‘My husband will say, what are all these squiggles here?’
When Julia saw the letter inviting her to take part in the SAFER feasibility study, she said to her husband: ‘Oh gosh, I am not sure I really want to do that’.
Julia’s husband had Atrial Fibrillation diagnosed some years ago, and now depends on a pacemaker.
She said: ‘He encouraged me to consider the study. I read the letter again and I thought, this looks like they are testing a means of identifying a condition that we know could be treated. And then I thought, well, I could get this monitor to use at home. Taking part in this research is a win-win situation. You’re getting a little bit of extra care. It’s really like a healthcare bonus.’
Julia explained, ‘I have a computer and a phone but it’s not a smartphone. So I did think, will I manage with the electronic device?’
She said: ‘We watched the little video showing you how to use it and I thought, I’m sure I can cope with that. And it really is incredibly simple. You just put your thumbs on the little buttons and then it tells you when to press send. Then off the information goes, and that’s it. We even took it on walks. You don’t have to think to yourself, I have to be at home. It was so easy it was unbelievable. On the days I was at home, I put stickies in the kitchen to make sure I used it, so I’d remember.’
Julia said: ‘It’s a great satisfaction to me that I might have contributed to helping diagnose AF at a point when it could be better treated’.
Photo: Julia Fox using the Zenicor device.