Utilization of point-of-care tests among general practitioners, a cross-sectional study

Abstract

Background Point-of-care testing (POCT) has numerous potential benefits to improve health care service, especially in resource-limited settings. We aim to identify which POC-tests (POCTs) of laboratory parameters are known, employed, and rated as useful by general practitioners (GPs). Methods A questionnaire with 27 POCTs was posted to a random selection of GPs (n = 451) in Saxony, Germany. Results A total of 208 GPs replied (response rate 46.1%). Out of 27 POCTs, each GP knew an average of 20.3 as laboratory parameters and 9.2 as POCTs. Urine test strips (99.0%), blood glucose test (98.1%), and Troponin I/T (86.4%) were the best-known, followed by INR/Quick (82.5%), Microalbumin (79.1%), and D-dimer (78.6%) POCTs. Yet, solely 0 to 13 POC tests were actually used (mean value 4.6). Urine test strips were employed most frequently (97.6%), followed by blood glucose test (94.7%), Troponin I/T (57.8%), Microalbumin (57.3%), and INR/Quick POCTs (41.7%). Heart fatty binding protein (H-FABP), Syphilis, Coeliac disease, and Malaria appeared as the least frequently used POCTs. The majority of the GPs declared 14 of the 27 POCTs to be useful. Discussion/conclusion The most recurrently employed POCTs are those for diagnosing or monitoring diabetes mellitus, ensued by POCTs addressing acute cardiovascular diseases (Troponin I/T, D-dimer) or monitoring the therapy of infectious diseases or the anticoagulant therapy. POCTs most often rated as useful by GPs are also widely known and frequently used. Nonetheless, the majority of GPs rate only a very limited number of POCTs as useful. Frequent concerns might be low economic benefit, over-reliance, and test accuracy coming along with the complex implementation of the tests requiring technical skills, accurate storage, and the correct interpretation of test results. Trial registration In accordance with the (Model) Professional Code for Physicians in Germany, neither human body materials nor data that can be assigned to a specific human being are used in our study. A declaration of no objection from the Ethics Committee of the Martin-Luther University Halle-Wittenberg (Medical Faculty) confirms no professional or ethical concerns due to completely anonymized data collection and analysis. Our study was therefore not registered in a corresponding registry.

Point-of-care laboratory testing in primary care: utilization, limitations and perspectives of general practitioners in Germany

“…Our results on the most frequently utilized POCTs are similar to a survey conducted among GPs in the German federal state of Saxony in early 2020 [ 7 ]. With the exception of SARS-CoV-2 rapid tests, all frequently utilized POCTs are available for in-vitro-diagnostic purposes since many years.…”

“…Numerous studies on POCTs in outpatient care were performed, predominantly investigating the diagnostic accuracy of POCTs [ 5 , 6 ]. However, as shown by a regional survey, GPs in Germany only utilize a relatively small number of POCTs in routine healthcare [ 7 ]. These tests include urine dipstick tests, glucose, troponin, microalbumin and D-dimer.…”

Point‐of‐care optical devices in clinical imaging and screening: A review on the state of the art

“…In this regard, point-of-care (POC) optical devices can significantly reduce the clinical turnaround time and aid in the screening of clinical samples [10]. In fact, the clinical practice has the vision to develop medical devices, designed to support the reliable and rapid screening of clinical conditions outside of the laboratory, especially in resource-constrained settings [11]. Laboratoryindependent POC-screening devices for tuberculosis, bacterial pneumonia, malaria, and syphilis could potentially minimize the death of 1.2 million people worldwide, annually [12][13][14].…”

Prehospital Targeting of 1-Year Mortality in Acute Chest Pain by Cardiac Biomarkers

“…The next step has entailed the development of devices capable of providing cardiac enzyme analysis, analogous to the ED test, in a reduced delay. In this sense, biomarkers such as troponin T (cTnT), N-terminal pro B-type natriuretic peptide (NT-proBNP), or D-dimer are already available for implementation in prehospital care [6][7][8].…”