Journal article
Point-of-care NT-proBNP monitoring for heart failure: observational feasibility study in primary care
- Abstract:
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Background Around one million individuals in the UK have heart failure (HF), a chronic disease that causes significant morbidity and mortality. N-terminal pro–B-type natriuretic peptide (NT-proBNP) monitoring could help improve the care of patients with HF in the community.
Aim The aim of this study is to provide evidence to support the routine use of point-of-care (POC) NT-proBNP monitoring in primary care.
Design & setting In this observational cohort study, the Roche Cobas h 232 POC device was used to measure NT-proBNP in 27 patients with HF at 0, 6 and 12 months, with a subset reanalysed in the laboratory for comparison.
Method Data were analysed for within- and between-person variability and concordance with laboratory readings using Passing–Bablok regression. GPs reported whether POC results impacted clinical decision-making, and patients indicated their willingness to participate in long-term cohort studies using the Likert acceptability scale.
Results Within-person variability in POC NT-proBNP over 12 months was 881 pg/mL (95% C.I. 380–1382 pg/mL). Between-person variability was 1972 pg/mL (95% C.I. 1,525–2791 pg/mL). Passing–Bablok regression showed no significant systematic difference between POC and laboratory measurements. Patients indicated a high level of acceptability, and GP decision-making was affected for at least one visit in a third of patients.
Conclusion Within person variability in POC NT-proBNP is around half of between-person variability, so detecting changes could be of use in HF management. High patient acceptability and impact on clinical decision-making warrant further investigation in a larger long-term cohort study.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 1.1MB, Terms of use)
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- Publisher copy:
- 10.3399/BJGPO.2022.0005
Authors
- Publisher:
- Royal College of General Practitioners
- Journal:
- BJGP Open More from this journal
- Volume:
- 6
- Issue:
- 3
- Article number:
- 2022.0005
- Publication date:
- 2022-09-28
- Acceptance date:
- 2022-02-01
- DOI:
- EISSN:
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2398-3795
- Language:
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English
- Keywords:
- Pubs id:
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1237080
- Local pid:
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pubs:1237080
- Deposit date:
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2022-01-31
Terms of use
- Copyright holder:
- Chami et al.
- Copyright date:
- 2022
- Rights statement:
- ©2022 The Author(s). This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License (http://creativecommons.org/licenses/by/4.0/). Published by BJGP Open. For editorial process and policies, see: https://bjgpopen.org/authors/bjgp-open-editorial-process-and-policies
- Licence:
- CC Attribution (CC BY)
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