Technology identities explain under- and non-adoption of community-based point-of-care tests in the UK NHS

2015 ◽  
Vol 4 (1) ◽  
pp. 68-77 ◽  
Author(s):  
Susan C. Peirce ◽  
Alex Faulkner ◽  
Selda Ulucanlar ◽  
Glyn Elwyn
Keyword(s):  
Point Of Care ◽  
Community Based ◽  
The Uk ◽  
Point Of Care Tests

scholarly journals Current and future use of point-of-care tests in primary care: an international survey in Australia, Belgium, The Netherlands, the UK and the USA

BMJ Open ◽  
2014 ◽  
Vol 4 (8) ◽  
pp. e005611-e005611 ◽  
Author(s):  
J. Howick ◽  
J. W. L. Cals ◽  
C. Jones ◽  
C. P. Price ◽  
A. Pluddemann ◽  
...  
Keyword(s):  
Primary Care ◽  
The Netherlands ◽  
Point Of Care ◽  
International Survey ◽  
The Usa ◽  
The Uk ◽  
Point Of Care Tests

scholarly journals The contribution of HIV point-of-care tests in early HIV diagnosis: community-based HIV testing monitoring in Catalonia, 1995 to 2018

2020 ◽  
Vol 25 (43) ◽  
Author(s):  
Laura Fernàndez-López ◽  
Juliana Reyes-Urueña ◽  
Anna Conway ◽  
Jorge Saz ◽  
Adriana Morales ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Screening Test ◽  
Point Of Care ◽  
Descriptive Analysis ◽  
Hiv Diagnosis ◽  
Community Based ◽  
Sex With Men ◽  
Hiv Continuum Of Care ◽  
Point Of Care Tests ◽  
The Impact

Background Community-based HIV testing services combined with the use of point-of-care tests (POCT) have the potential to improve early diagnosis through increasing availability, accessibility and uptake of HIV testing. Aim To describe community-based HIV testing activity in Catalonia, Spain, from 1995 to 2018, and to evaluate the impact of HIV POCT on the HIV continuum of care. Methods A community-based network of voluntary counselling and testing services in Catalonia, Spain has been collecting systematic data on activity, process and results since 1995. A descriptive analysis was performed on pooled data, describing the data in terms of people tested and reactive screening test results. Results Between 1995 and 2018, 125,876 HIV tests were performed (2.1% reactive). Since the introduction of HIV POCT in 2007, a large increase in the number of tests performed was observed, reaching 14,537 tests alone in 2018 (1.3% reactive). Men who have sex with men (MSM), as a proportion of all people tested, has increased greatly over time reaching 74.7% in 2018. The highest percentage of reactive tests was found in people who inject drugs followed by MSM. The contribution of community-based HIV testing to the overall total notified cases in the Catalonia HIV registry has gradually increased, reaching 37.9% in 2018, and 70% of all MSM cases. In 2018, the percentage of individuals with a reactive screening test who were linked to care was 89.0%. Conclusion Our study reinforces the important role that community-based HIV POCT has on the diagnosis of HIV in key populations.

scholarly journals High Variability in Sepsis Guidelines in UK: Why Does It Matter?

2020 ◽  
Vol 17 (6) ◽  
pp. 2026
Author(s):  
Alison Bray ◽  
Emmanouela Kampouraki ◽  
Amanda Winter ◽  
Aaron Jesuthasan ◽  
Ben Messer ◽  
...  
Keyword(s):  
Large Scale ◽  
Care Pathway ◽  
Point Of Care ◽  
Early Warning Score ◽  
Economic Evaluations ◽  
Societal Costs ◽  
Potential Impact ◽  
The Uk ◽  
Point Of Care Tests ◽  
Clinical Audits

It is recommended that developers of Point Of Care Tests (POCTs) assess the care pathway of the patient population of interest in order to understand if the POCT fits within the pathway and has the potential to improve it. If the variation of the pathway across potential hospitals is large, then it is likely that the evaluation of effectiveness is harder and the route towards large-scale takes adoption longer. Evaluating care pathways can be a time-consuming activity when conducted through clinical audits or interviews with healthcare professionals. We have developed a more rapid methodology which extrapolates the care pathway from local hospital guidelines and assesses their variation. Sepsis kills 46,000 people per year in the UK with societal costs of up to £10 billion. Therefore, there is a clinical need for an optimized pathway. By applying our method in this field, we were able to assess the variation in current hospital guidelines for sepsis and infer the potential impact this may have on the evidence development on innovations in this applications. We obtained 15 local sepsis guidelines. Two independent reviewers extracted: use of the national early warning score (NEWS), signs and risk factors informing the decision to prescribe antibiotics, and the number of decisional steps up to this point. Considerable variation was observed in all the variables, which is likely to have an impact on future clinical and economic evaluations and adoption of POCT for the identification of patients with sepsis.

scholarly journals Qualitative analysis of stakeholder interviews to identify the barriers and facilitators to the adoption of point-of-care diagnostic tests in the UK

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e042944
Author(s):  
Jeremy R Huddy ◽  
Melody Zhifang Ni ◽  
James Barlow ◽  
George B Hanna
Keyword(s):  
Resource Use ◽  
Point Of Care ◽  
Financial Resource ◽  
Barriers And Facilitators ◽  
Patient Factors ◽  
Laboratory Staff ◽  
Device Development ◽  
The Uk ◽  
Point Of Care Tests ◽  
Constant Comparative Analysis

ObjectivesThis study investigated the barriers and facilitators to the adoption of point-of-care tests (POCTs).DesignQualitative study incorporating a constant comparative analysis of stakeholder responses to a series of interviews undertaken to design the Point-of-Care Key Evidence Tool.SettingThe study was conducted in relation to POCTs used in all aspects of healthcare.ParticipantsForty-three stakeholders were interviewed including clinicians (incorporating laboratory staff and members of trust POCT committees), commissioners, industry, regulators and patients.ResultsThematic analysis highlighted 32 barriers in six themes and 28 facilitators in eight themes to the adoption of POCTs. Six themes were common to both barriers and facilitators (clinical, cultural, evidence, design and quality assurance, financial and organisational) and two themes contained facilitators alone (patient factors and other (non-financial) resource use).ConclusionsFindings from this study demonstrate the complex motivations of stakeholders in the adoption of POCT. Most themes were common to both barriers and facilitators suggesting that good device design, stakeholder engagement and appropriate evidence provision can increase the likelihood of a POCT device adoption. However, it is important to realise that while the majority of identified barriers may be perceived or mitigated some may be absolute and if identified early in device development further investment should be carefully considered.

Clinical Reliability of point-of-care tests to support community based acute ambulatory care

2020 ◽  
Vol 19 (1) ◽  
pp. 4-14
Author(s):  
Jan Y Verbakel ◽  
◽  
Charlotte Richardson ◽  
Tania Elias ◽  
Jordan Bowen ◽  
...  
Keyword(s):  
Ambulatory Care ◽  
Clinical Chemistry ◽  
Point Of Care ◽  
Community Dwelling ◽  
Central Laboratory ◽  
Point Of Care Testing ◽  
Community Based ◽  
Sodium Potassium ◽  
Point Of Care Tests ◽  
Acceptable Agreement

Objective: To ensure clinicians can rely on point-of-care testing results, we assessed agreement between point-of-care tests for creatinine, urea, sodium, potassium, calcium, Hb, INR, CRP and subsequent corresponding laboratory tests. Participants: Community-dwelling adults referred to a community-based acute ambulatory care unit. Interventions: The Abbott i-STATTM (Hb, clinical chemistry, INR) and the AfinionTM Analyser (CRP) and corresponding laboratory analyses. Outcomes: Agreement (Bland-Altman) and bias (Passing-Bablok regression). Results: Among 462 adults we found an absolute mean difference between point-of-care and central laboratory analyses of 6.4g/L (95%LOA -7.9 to +20.6) for haemoglobin, -0.5mmol/L (95%LOA -4.5 to +3.5) for sodium, 0.2mmol/L (95%LOA -0.6 to +0.9) for potassium, 0.0mmol/L (95%LOA -0.3 to +0.3) for calcium, 9.0 μmol/L (95%LOA -18.5 to +36.4) for creatinine, 0.0mmol/L (95%LOA -2.7 to +2.6) for urea, -0.2 (95%LOA -2.4 to +2.0) for INR, -5.0 mg/L (95%LOA -24.4 to +14.4) for CRP. Conclusions: There was acceptable agreement and bias for these analytes, except for haemoglobin and creatinine.

scholarly journals Young people’s experiences with clinical care and preferences for delivery of new point-of-care tests for STIs in England

2019 ◽  
Author(s):  
Hannah McCulloch ◽  
Agata Pacho ◽  
Rebecca Geary ◽  
Syed Tariq Sadiq ◽  
Sebastian Fuller
Keyword(s):  
Young People ◽  
Clinical Pathways ◽  
Point Of Care ◽  
Clinical Care ◽  
Sex With Men ◽  
Sexual Health Clinics ◽  
The Uk ◽  
Point Of Care Tests ◽  
Implementation Plans ◽  
Precise Study

BackgroundYoung people in the UK are at high risk for sexually transmitted infections (STIs), despite STI testing being freely and confidentially available. Given multiple barriers they may face for attending sexual health clinics (SHCs), young people should be consulted regarding changes to care. Studies have shown that point-of-care tests (POCTs) for STIs, which can accurately diagnose and treat patients in one clinical visit, have potential for individual and public health benefits, yet patient opinions of changes to clinical practice associated with POCT implementation are less understood.MethodsThe Precise study explored patient experiences of UK SHC services and their opinions of POCT implementation plans; here we focus on young participants within the Precise study. Male and female attendees of three SHCs in England were purposively sampled and then invited to participate in a qualitative in-depth interview. Interviews were conducted one-on-one, in person or via telephone, were audio-recorded and transcribed. NVivo (V10) was used to organise data for our content-based analysis.ResultsTen young people aged 17-22 years, including: three women-who-have-sex-with-men, four men-who-have-sex-with-women and three men-who-have-sex-with-men were interviewed between June 2015 and February 2016. Participants reported SHCs as the best place to receive results because treatment could be stared immediately, with advice and information available. Participants discussed the potential for POCTs to reduce anxiety currently felt waiting for laboratory results. POCTs were found broadly acceptable, and were generally regarded as an innovation to improve SHC experiences. Participants with less previous SHC experience raised concerns that implementation of POCTs could negatively affect the amount and quality of time patients spend in consultations with clinicians and that changes to pathways may cause confusion in clinic.ConclusionsWe advise POCT implementation be accompanied by SHC staff communicating changes in clinical pathways to patients, including method and timeline for receiving results. Our participants valued face-to-face counselling and advice currently experienced in SHCs; these findings emphasise that POCT implementation plans safe-guard these aspects of care. Our findings suggest that POCT implementation in SHCs has potential to improve young people’s clinical experiences, which may facilitate attendance.

Re-challenging antibiotic resistance with Daniel Berman

2020 ◽  
Author(s):  
Daniel Berman
Keyword(s):  
Bacterial Infections ◽  
Point Of Care ◽  
Healthcare Setting ◽  
Rapid Diagnostic Tests ◽  
Resistant Bacteria ◽  
Drug Resistant ◽  
Drug Resistant Bacteria ◽  
Global Threat ◽  
The Right ◽  
Point Of Care Tests

How can we prevent the rise of resistance to antibiotics? In this video, Daniel Berman,  Nesta Challenges, discusses the global threat of AMR and how prizes like the Longitude Prize can foster the development of rapid diagnostic tests for bacterial infections, helping to contribute towards reducing the global threat of drug resistant bacteria. Daniel outlines how accelerating the development of rapid point-of-care tests will ensure that bacterial infections are treated with the most appropriate antibiotic, at the right time and in the right healthcare setting.

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