Point-of-care diagnostic technology in paediatric ambulatory care: a qualitative interview study of English clinicians and stakeholders

Abstract

Point-of-care (POC) tests have the potential to improve paediatric healthcare. However, both the development and evaluation of POC technology have almost solely been focused on adults. We aimed to explore frontline clinicians’ and stakeholders’ current experience of POC diagnostic technology in children in England; and to identify areas of unmet need.Design, setting and participantsQualitative semistructured telephone interviews were carried out with purposively sampled participants from clinical paediatric ambulatory care and charity, industry and policymaking stakeholders. The interviews were audio-recorded, transcribed and analysed thematically.ResultsWe interviewed 19 clinicians and 8 stakeholders. The main perceived benefits of POC tests and technologies were that they aided early decision-making and could be convenient and empowering when used independently by patients and families. Clinicians and stakeholders wanted more POC tests to be available for use in clinical practice. Most recognised that play and reward are important components of successful POC tests for children. Clinicians wanted tests to give them answers, which would result in a change in their clinical management. Detecting acute serious illness, notably distinguishing viral and bacterial infection, was perceived to be an area where tests could add value. POC tests were thought to be particularly useful for children presenting atypically, where diagnosis was more challenging, such as those less able to communicate, and for rare serious diseases. Many participants felt they could be useful in managing chronic disease.ConclusionsThis exploratory study found that clinicians and stakeholders supported the use of diagnostic POC technology in paediatric ambulatory care settings in England. Some existing tests are not fit for purpose and could be refined. Industry should be encouraged to develop new child-friendly tests tackling areas of unmet need, guided by the preferred characteristics of those working on the ground.

Stakeholders’ views and experiences on implementing new diagnostics in primary care to support management of community-acquired acute respiratory tract infections: a qualitative study

“…To date, there are limited qualitative studies that explore stakeholders’ views and experiences on implementation of POCTs for CA-ARTI. Qualitative studies conducted in the UK involved stakeholders with similar roles to our study but took place prior to the pandemic ( 7 , 13 ) while another focussed on pediatric ambulatory care ( 14 ). These studies, however, reported similar findings to our UK data and extended to our EU and Belgian data ( 7 , 13 ).…”

“…Qualitative studies understanding the perspectives of stakeholders who are instrumental to the implementation process, therefore, may provide insights into some of the factors that influence uptake of POCTs in primary care settings. To date, evidence on barriers and facilitators to implementing CA-ARTI-specific POCTs from the perspectives of stakeholders in Europe have been limited to studies in the UK ( 7 , 13 , 14 ). UK studies on stakeholders, that held similar roles to those recruited in this study, were conducted prior to the pandemic or focussed on pediatric ambulatory care ( 7 , 13 , 14 ).…”

“…To date, evidence on barriers and facilitators to implementing CA-ARTI-specific POCTs from the perspectives of stakeholders in Europe have been limited to studies in the UK ( 7 , 13 , 14 ). UK studies on stakeholders, that held similar roles to those recruited in this study, were conducted prior to the pandemic or focussed on pediatric ambulatory care ( 7 , 13 , 14 ). These studies illustrated that technology design, stakeholder engagement, and sufficient evidence on utility aid adoption.…”