Analytical quality and effectiveness of point-of-care testing in community pharmacies: A systematic literature review

Buss, Vera Helen; Deeks, Louise S; Shield, Alison; Kosari, Sam; Naunton, Mark

doi:10.1016/j.sapharm.2018.07.013

Cited by 24 publications

(18 citation statements)

References 40 publications

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“…Results suggest that the STTT service is using the skills of pharmacists more effectively and that pharmacists make appropriate clinical decisions, providing self-care, referring to other healthcare professionals where needed. This finding is consistent with the recommendations of Jones et al ,25 that pharmacists can play a role in antimicrobial stewardship by being part of a coordinated approach to promote appropriate use of antibiotics and therefore contribute to tackling AMR, and Buss et al who reviewed the literature on point-of-care tests conducted in community pharmacies and concluded that pharmacies are well suited to deliver a wide range of such tests 26…”

Section: Discussionsupporting

confidence: 87%

Impact of a pilot NHS-funded sore throat test and treat service in community pharmacies on provision and quality of patient care

et al. 2020

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ObjectiveA National Health Service (NHS)-funded sore throat test and treat (STTT) service was introduced in selected pharmacies in two local health boards in Wales, as an extension to the national pharmacy common ailment scheme. The aim of this study was to evaluate the impact of STTT on provision and quality of patient care, namely antibiotic use, patient safety and general practitioner (GP) consultation rates.MethodsSecondary analyses of STTT consultation data to describe service outcomes, and routine data to explore changes in antibiotic prescribing and the prevalence of complications. Data were also collected from one GP practice to explore the feasibility of measuring changes in sore throat consultation rates in general practice.ResultsLess than 20% of 1725 consultations resulted in antibiotic supply. The availability of STTT was associated with greater reductions in prescriptions for phenoxymethylpenicillin than in areas where STTT was not available (−3.8% and −3.4%, difference 0.4%). When pharmacy supplies were included, the reductions in the supply of the antibiotic were similar. No increase in the monthly number of incidents of quinsy was detected, and patients were appropriately referred to other healthcare professionals during pharmacy consultations. GP consultation rates since introduction of STTT were found to be lower than the equivalent monthly average since 2014.ConclusionsData from the first 5 months of the STTT service suggest that it may have a role in safely rebalancing uncomplicated sore throat management from general practice to community pharmacies while continuing to promote antibiotic stewardship.

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Section: Discussionsupporting

confidence: 87%

Impact of a pilot NHS-funded sore throat test and treat service in community pharmacies on provision and quality of patient care

et al. 2020

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“…The use of POCT in community pharmacy has been explored by Buss et al and identified as useful for supporting pharmacists' decision-making. 6 Several schemes have been piloted in the UK and internationally whereby sore throat management in the community pharmacy is being augmented by POCT, [7][8][9][10] but there is little research reporting the experience of patients who use such schemes. The pilot of the first NHS funded Sore Throat Test and Treat (STTT) service in the UK was introduced in selected community pharmacies in Wales in November 2018.…”

Section: Introductionmentioning

confidence: 99%

Understanding the impact of a new pharmacy sore throat test and treat service on patient experience: A survey study

Mantzourani

Cannings‐John

Evans

et al. 2021

Research in Social and Administrative Pharmacy

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Background: A pilot of the first NHS funded Sore Throat Test and Treat (STTT) service in the United Kingdom began in selected community pharmacies in Wales in November 2018. The aim of this research was to explore whether a pharmacist delivering consultation for sore throat that included clinical scoring and point-of-care testing was acceptable to patients, and how this might influence future health-seeking behaviour. Methods: A non-experimental design was employed using a survey research tool including a mix of closed and open questions. The patient experience survey was distributed to all patients who had completed a consultation between November 2018 and May 2019. Data from completed surveys were entered in Jisc Online Surveys® and exported to Excel® for descriptive statistics. Free-text comments were analysed using content and inductive thematic analysis. Results: A total of 510 surveys were received (n=2,839 total consultations, response rate 18%). Overall, 501 patients (98%) were satisfied with the service. Patients' confidence in managing their condition and service satisfaction was not dependent on having been supplied antibiotics. After the service, 504 patients (99%) stated that they would return to the pharmacy for subsequent sore throat symptoms. Three themes were constructed after inductive analysis of free-text comments (n=242): convenience and accessibility; professionalism of pharmacy team; and perceived value of the service. Conclusions: Results confirmed high levels of patient satisfaction with the new service, its delivery and the choice of options offered for sore throat symptom management. Whilst this research can only discuss patients' reported future behaviour, the patient-reported stated intentions signify a potential shift in healthseeking behaviour towards a pharmacist-led service. This has important implications in supporting the long-term plan of the governments in Wales and England to redirect management of uncomplicated conditions from GPs to pharmacies.

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“…Comparison with previous literature A systematic review published in 2018 by Buss et al aimed to summarise the literature related to both analytical quality and effectiveness of POCT in pharmacies. 10 Unlike our review, Buss et al included studies where pharmacy POCT performance was compared with corresponding laboratory results. Our review included the two studies contained within Buss et al that compared pharmacy POCT with a control.…”

Section: Open Accessmentioning

confidence: 99%

“…8 The evidence-base for implementing POCTs remains a concern more generally given that studies tend to focus on test performance (method comparison with central laboratory testing) rather than clinical or healthcare utilisation outcomes. 9 While previous work has focussed on the analytical quality of POCTs used by community pharmacists, 10 this paper presents the findings of a systematic review and meta-analysis assessing the clinical impact of POCTs in community pharmacies on clinical outcomes and healthcare processes. such that the effect of the POCT alone could not be ascertained.…”

Section: Introductionmentioning

confidence: 99%

Impact of point-of-care tests in community pharmacies: a systematic review and meta-analysis

et al. 2020

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ObjectivesTo summarise the literature regarding the use of point-of-care test (POCT) in pharmacies versus control/usual care.Design and settingSystematic review and random-effects meta-analysis in community pharmacy.Data sourcesMEDLINE, Cochrane Central Register of Controlled Trials, Embase, ClinicalTrial.gov and Web of Science databases were searched.Eligibility criteriaArticles were included if they: involved a POCT conducted by a community pharmacist, member of pharmacy staff or local equivalent; measured a clinically relevant outcome for example, clinical parameter monitoring. No clinical condition or language limits were set.Patient and public involvementNo patient involvement.Data extraction and synthesisData were independently extracted by two members of the review team to capture changes in clinical care that resulted from the use of the POCTs. The methodological quality of included studies was assessed, using the Cochrane Risk of Bias tool and Newcastle-Ottawa scale.ResultsThirteen of the 1584 articles found were included in the meta-analyses. Studies covered four therapeutic areas: targeted anti-malarial therapy (n=3 studies), glycated haemoglobin (HbA1c) in diabetes (n=2 studies), lipid control (n=3 studies) and international normalised ratio (INR) control in patients taking warfarin (n=5 studies). POCT in pharmacies reduced the risk of receiving antimalarial treatment when not clinically indicated (risk ratio 0.34, 95% CI 0.31 to 0.37). Lipid and HbA1c control appeared largely unaffected by pharmacy POCTs, and the impact on INR time-in-therapeutic-range was inconclusive.ConclusionsOnly 4 out of 13 included studies used a gold-standard randomised controlled trial (RCT) design, limiting our ability to conclusively determine the clinical utility of POCT conducted in pharmacies. Further RCTs are needed, particularly in areas such as upper respiratory tract infections, which have gathered momentum among service commissioners in recent years.PROSPERO registration numberCRD42017048578.

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Analytical quality and effectiveness of point-of-care testing in community pharmacies: A systematic literature review

Cited by 24 publications

References 40 publications

Impact of a pilot NHS-funded sore throat test and treat service in community pharmacies on provision and quality of patient care

Impact of a pilot NHS-funded sore throat test and treat service in community pharmacies on provision and quality of patient care

Understanding the impact of a new pharmacy sore throat test and treat service on patient experience: A survey study

Impact of point-of-care tests in community pharmacies: a systematic review and meta-analysis

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