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Journal article : Review

Point-of-care testing in private pharmacy and drug retail settings: a narrative review

Abstract:

Background: Point-of-care testing (POCT) using rapid diagnostic tests for infectious disease can potentially guide appropriate use of antimicrobials, reduce antimicrobial resistance, and economise use of healthcare resources. POCT implementation in private retail settings such as pharmacies and drug shops could lessen the burden on public healthcare. We performed a narrative review on studies of POCTs in low- and middle-income countries (LMICs), and explored uptake, impact on treatment, and feasibility of implementation.

Methods: We searched MEDLINE/PubMed for interventional studies on the implementation of POCT for infectious diseases performed by personnel in private retail settings. Data were extracted and analysed by two independent reviewers.

Results: Of the 848 studies retrieved, 23 were included in the review. Studies were on malaria (19/23), malaria and pneumonia (3/23) or respiratory tract infection (1/23). Nine randomised controlled studies, four controlled, non-randomised studies, five uncontrolled interventions, one interventional pre-post study, one cross-over interventional study and three retrospective analyses of RCTs were included. Study quality was poor. Overall, studies showed that POCT can be implemented successfully, leading to improvements in appropriate treatment as measured by outcomes like adherence to treatment guidelines. Despite some concerns by health workers, customers and shop providers were welcoming of POCT implementation in private retail settings. Main themes that arose from the review included the need for well-structured training with post-training certification covering guidelines for test-negative patients, integrated waste management, community sensitization and demand generation activities, financial remuneration and pricing schemes for providers, and formal linkage to healthcare and support.

Conclusion: Our review found evidence that POCT can be implemented successfully in private retail settings in LMICs, but comprehensive protocols are needed. High-quality randomised studies are needed to understand POCTs for infectious diseases other than malaria.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1186/s12879-023-08480-w

Authors

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Role:
Author
ORCID:
0000-0002-6799-6477
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Institution:
University of Oxford
Division:
MSD
Department:
Primary Care Health Sciences
Role:
Author


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Funder identifier:
https://ror.org/03x94j517
Grant:
MR/S001964/1


Publisher:
Springer
Journal:
BMC Infectious Diseases More from this journal
Volume:
23
Issue:
1
Article number:
551
Publication date:
2023-08-23
Acceptance date:
2023-07-23
DOI:
EISSN:
1471-2334
Pmid:
37612636


Language:
English
Keywords:
Subtype:
Review
Pubs id:
1518471
Local pid:
pubs:1518471
Deposit date:
2025-04-23
ARK identifier:

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