Point-of-Care Testing for SARS-CoV-2: A Prospective Study in a Primary Health Centre

Daniels, Rob; Cottin, Judith; Khanafer, Nagham

doi:10.3390/diagnostics13111888

Cited by 3 publications

(7 citation statements)

References 22 publications

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“…Interestingly, a primary care study using lateral flow tests also noted a trend in reduced antibiotic prescriptions in children presenting a sore throat score over 3 and noted that prescriptions were provided due to a lack of trust in the lateral test result [ 21 ]. In this study, both patients and doctors trusted the outcome of the rapid molecular test, which corresponds to opinions and attitudes observed in earlier studies carried out in primary care sectors [ 14 , 15 , 16 ].…”

Section: Discussionsupporting

confidence: 80%

“…The uptake of POC testing has been slow in primary care, and a study undertaken in Ireland [ 13 ] revealed that GPs perceive point-of-care tests as beneficial and would welcome their use in routine clinical practice, citing guidance in decision making as the primary benefit (43%), followed by reduced referral rates (29%) and assistance in diagnosis (13%) [ 13 ]. Moreover, during the COVID-19 pandemic, studies in primary care practices in Germany and the United Kingdom using molecular testing reported patient satisfaction in terms of prompt testing and trusted results, reduced further testing and improved workflow and better patient care for high-risk groups [ 14 , 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Does the Addition of Point-of-Care Testing Alter Antibiotic Prescribing Decisions When Patients Present with Acute Sore Throat to Primary Care? A Prospective Test of Change

Daniels,

Miles,

Button

2024

Diagnostics

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Accurate clinical diagnosis of patients presenting to primary care settings with acute sore throat remains challenging, often resulting in the over-prescribing of antibiotics. Using point-of-care tests (POCTs) to differentiate between respiratory infections is well-accepted, yet evidence on the application within primary care is sparse. We assessed the application of testing patients (n = 160) from three family practices with suspected Streptococcal infections using rapid molecular tests (ID NOW Strep A2, Abbott). In addition to comparing clinical evaluation and prescription rates with either usual care or testing, patients and staff completed a questionnaire about their experience of molecular POCT in primary care. The immediate availability of the result was important to patients (100%), and staff (≈90%) stated that molecular testing improved the quality of care. Interestingly, only 22.73% of patients with a Centor score > 2 tested positive for Strep A and, overall, less than 50% of Centor scores 3 and 4 tested positive for Strep A with the ID NOW testing platform. The addition of rapid molecular POCTs to clinical assessment resulted in a 55–65% reduction in immediate and deferred antibiotic prescriptions. The intervention was popular with patients and medical staff but was associated with increased cost and a longer appointment length.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Does the Addition of Point-of-Care Testing Alter Antibiotic Prescribing Decisions When Patients Present with Acute Sore Throat to Primary Care? A Prospective Test of Change

Daniels,

Miles,

Button

2024

Diagnostics

Self Cite

View full text Add to dashboard Cite

show abstract

“…Interestingly, a primary care study using lateral flow tests also noted a trend in reduced antibiotic prescriptions in children presenting a sore throat score over 3 and noted that prescriptions were provided due to lack of trust in the lateral test result [26]. In this study both patients and doctors trusted the outcome of the rapid molecular test which corresponds to opinions and attitudes observed in earlier studies carried out in primary care sectors [14][15][16].…”

Section: Discussionsupporting

confidence: 76%

“…As well as Strep A, the platform can detect viral infections (influenza A&B, RSV and SARS-CoV-2), making it a potentially useful adjunct to standard clinical assessments and has been shown in hospitals settings to improve clinical managements of patients, reduce antibiotic prescription rates and reduce unnecessary secondary testing [22][23][24][25]. Previously, this group and others have assessed the practicality of implementing rapid molecular POCT for SARS-CoV-2 into primary care settings [16]. During the evaluation period here, it was determined if POCT improved the clinical diagnosis of Strep A when compared to usual care (Figure 2).…”

Section: Molecular Poct Increases the Diagnostic Accuracy Of Clinical...mentioning

confidence: 99%

“…Among the total of 143 participants, 92 of them indicated their interest in accessing POCTs, citing guidance in decision making as the primary benefit (43%), followed by reduced referral rates (29%) and assistance in diagnosis (13%) [13]. Moreover, during the Covid-19 pandemic, studies in primary care practices in Germany and the United Kingdom using molecular testing showed patient satisfaction in terms of prompt testing and trusted results, reduced further testing and improved workflow and better patient care for high-risk groups [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Does Point of Care Testing Reduce Antibiotic Prescribing in Patients Presenting with Acute Sore Throat to Primary Care? A Prospective Test of Change

Daniels,

Miles,

Button

2024

Preprint

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Accurate clinical diagnosis of patients presenting to primary care settings with acute sore throat remains challenging, often resulting in the over-prescribing of antibiotics. Using point-of-care tests (POCTs) to differentiate between respiratory infections is well-accepted, yet evidence on the application within primary care is sparse. We assessed the application of testing patients (n=160) from three family practices with suspected Streptococcal infections using rapid molecular tests (ID NOW Strep A2, Abbott). In addition to comparing clinical evaluation and prescription rates with either usual care or with testing, patients and staff completed a questionnaire about their experience of molecular POCT in primary care. The immediate availability of the result was important to patients (100%) and staff (≈90%) stated that molecular testing improved quality of care. Interestingly, only 22.73% of patients with a Centor score >2 tested positive for Strep A and overall, less than 50% of Centor scores 3 and 4 tested positive for Strep A with the ID NOW testing platform. The addition of rapid molecular POCTs to clinical assessment resulted in a 55- 65% reduction in immediate and deferred antibiotic prescriptions. The intervention was popular with patients and medical staff but was associated with increased cost and a longer appointment length.

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Interventions to Improve Patient Safety During the Covid-19 Pandemic: A Systematic Review

Wu,

Trigg,

Zhang

et al. 2024

Preprint

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ObjectiveTo summarize the literature on health care interventions to reduce harm to patients caused by the COVID-19 pandemic across six domains: medication errors, diagnostic errors, surgical errors, health care-associated infections, pressure injuries, and falls.MethodsWe performed a mixed methods systematic review, with the intention to present results narratively. We combined parallel searches and experiential evidence across each domain of interest. We included studies published between 11 March 2020 and 28 August 2023 that reported an intervention in response to an identified patient safety issue. We identified 13,019 unique articles across the six domains. Of these, 590 full texts were assessed for eligibility. Seven were included for the medication safety domain; seven for diagnostic safety; 32 for surgical safety; 11 for health care-associated infections; six for the pressure injuries; and two for falls (Annex C). Overall, a total of 61 unique articles were included – four articles were represented across more than one domain.FindingsThere were few rigorous evaluations of specific interventions to reduce patient harm caused by the pandemic. Adjustments in treatments, triage, and procedures, and use of risk stratification tools reduced delays and permitted more elective surgery and diagnostic testing to proceed, improvements in medication safety practices, and prevention of health care-associated infections. Publications emphasized the importance of implementing existing practices and following the latest guidelines to prevent health care-associated infections, medication errors, pressure injuries and falls.ConclusionThere is little research on interventions to reduce patient harm caused in health care settings during the COVID-19 pandemic. Interventions focused on preventing nosocomial transmission of COVID-19, and on permitting access to urgent surgical and diagnostic needs. A few studies tested strategies to reduce new risks imposed by the pandemic for medication errors, health care-associated infections, pressure injuries, and falls. They also urged extra efforts to implement existing practices and following the latest guidelines already known to be effective. Development of high-reliability health systems and health care organizations to protect patients and health workers from harm, will be essential to mitigating the impact of future pandemics within the objectives of the Global Patient Safety Action Plan 2021-2030.

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Point-of-Care Testing for SARS-CoV-2: A Prospective Study in a Primary Health Centre

Cited by 3 publications

References 22 publications

Does the Addition of Point-of-Care Testing Alter Antibiotic Prescribing Decisions When Patients Present with Acute Sore Throat to Primary Care? A Prospective Test of Change

Does the Addition of Point-of-Care Testing Alter Antibiotic Prescribing Decisions When Patients Present with Acute Sore Throat to Primary Care? A Prospective Test of Change

Does Point of Care Testing Reduce Antibiotic Prescribing in Patients Presenting with Acute Sore Throat to Primary Care? A Prospective Test of Change

Interventions to Improve Patient Safety During the Covid-19 Pandemic: A Systematic Review

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