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Implementing in-vitro diagnostic point-of-care tests in community health care: how can we make this work?

Abstract:

In-vitro diagnostic point-of-care tests (POCTs) are performed across a broad range of sample types, with professional and self-administered POCTs gaining widespread familiarity during the SARS-CoV-2 pandemic. POCTs can rapidly inform clinical decisions, with potential benefits including the optimisation of disease management and referrals, reduction in healthcare costs, increased patient satisfaction, and better treatment adherence. Surveys have identified POCTs that GPs believed could be helpful and conditions where they considered that POCTs, if available, could support clinical decision making.1,2

Community-based health care is responsible for high volumes of activity (the majority of NHS contacts),3 dealing with largely undifferentiated patient populations, incorporating a high proportion of conditions that need minimal intervention or are self-limiting, but also low-prevalence, potentially serious conditions that require prompt, appropriate management. Community health care plays a fundamental role in disease prevention and the management of long-term conditions.

Implementation of POCTs in UK community health care does not currently align with the desire for POCTs reported previously.1,2 Evaluating evidence quality for the use of POCTs is crucial to support implementation decision making. While clinical performance is commonly studied, areas such as clinical effectiveness, cost-effectiveness, and broader impact are less frequently evaluated.4 A systematic review of implementation of 83 POCTs showed that clinical utility was of paramount importance for GPs, yet was rarely assessed.5 Limited community implementation of POCTs may be partly attributable to a lack of understanding of the elements required to achieve success. These include: GPs’ concerns about clinical utility; access to laboratory and diagnostic technology expertise; provision of funding, training, and support models; sound implementation strategies; and evidence-based monitoring.6,7

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.3399/bjgp25X741153

Authors

More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Primary Care Health Sciences
Role:
Author
ORCID:
0000-0001-7299-8939
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Primary Care Health Sciences
Role:
Author
ORCID:
0009-0001-1009-4309
More by this author
Role:
Author
ORCID:
0000-0002-0511-9305
More by this author
Role:
Author
ORCID:
0000-0002-5382-9838
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Primary Care Health Sciences
Role:
Author


Publisher:
Royal College of General Practitioners
Journal:
British Journal of General Practice More from this journal
Volume:
75
Issue:
753
Pages:
182-185
Publication date:
2025-03-27
DOI:
EISSN:
1478-5242
ISSN:
0960-1643


Language:
English
Keywords:
Pubs id:
2101329
Local pid:
pubs:2101329
Source identifiers:
W4408896449
Deposit date:
2025-03-31
ARK identifier:

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