Implementation of HbA1c Point of Care Testing in 3 German Medical Practices: Impact on Workflow and Physician, Staff, and Patient Satisfaction

Patzer, Karl-Heinz; Ardjomand, Payam; Göhring, Katharina; Klempt, Guido; Patzelt, Andreas; Redzich, M; Zebrowski, M; Emmerich, Susanne; Schnell, Oliver

doi:10.1177/1932296818759690

Cited by 16 publications

(15 citation statements)

References 18 publications

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“…Evidence suggests that use of point-of-care testing to monitor intermediate markers of chronic disease, such as lipid profiles, glycated haemoglobin, and albumin-creatinine ratios improves practice workflow and increases satisfaction of clinicians, other primary care staff, and patients 1011. Point-of-care testing might also reduce costs, save time, and minimise non-attendance—freeing up valuable clinical time, and research should now be done on these important outcomes.…”

Section: Priorities For Actionmentioning

confidence: 99%

Pandemic threatens primary care for long term conditions

Levene

Seidu

Greenhalgh

et al. 2020

BMJ

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During the height of the covid-19 pandemic, attention was diverted away from primary care's key roles in early detection of disease and management of long term conditions. However, the core primary healthcare functions of accessible first contact, comprehensiveness, coordination, continuity, and person centredness were challenged even before this. 1 General practices' workloads have steadily risen in the past decade. In England between 2010-11 and 2019, the overall number of consultations per registered patient each year rose from 4.29 to 5.17 2 3 in a growing population.

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Section: Priorities For Actionmentioning

confidence: 99%

Pandemic threatens primary care for long term conditions

Levene

Seidu

Greenhalgh

et al. 2020

BMJ

View full text Add to dashboard Cite

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“…Previous studies have examined the use of POC-A1c devices in hospitals ( Patzer et al, 2018 ) or for early diagnosis in tertiary care ( Gomez-Peralta et al, 2016 ). It was found to improve blood glucose levels in primary care ( Motta et al, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness of Point-of-Care A1C Tests in a Primary Care Setting

et al. 2021

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Objective: We evaluated the cost-effectiveness of the point-of-care A1c (POC-A1c) test device vs. the traditional laboratory dosage in a primary care setting for people living with type 2 diabetes.Materials and Methods: The Markov model with a 10-year time horizon was based on data from the HealthRise project, in which a group of interventions was implemented to improve diabetes and hypertension control in the primary care network of the urban area of a Brazilian municipality. A POC-A1c device was provided to be used directly in a primary care unit, and for a period of 18 months, 288 patients were included in the point-of-care group, and 1,102 were included in the comparison group. Sensitivity analysis was performed via Monte Carlo simulation and tornado diagram.Results: The results indicated that the POC-A1c device used in the primary care unit was a cost-effective alternative, which improved access to A1c tests and resulted in an increased rate of early control of blood glucose. In the 10-year period, POC-A1c group presented a mean cost of US$10,503.48 per patient and an effectiveness of 0.35 vs. US$9,992.35 and 0.09 for the traditional laboratory test, respectively. The incremental cost was US$511.13 and the incremental effectiveness was 0.26, resulting in an incremental cost-effectiveness ratio of 1,947.10. In Monte Carlo simulation, costs and effectiveness ranged between $9,663.20–$10,683.53 and 0.33–0.37 for POC-A1c test group, and $9,288.28–$10,413.99 and 0.08–0.10 for traditional laboratory test group, at 2.5 and 97.5 percentiles. The costs for nephropathy, retinopathy, and cardiovascular disease and the probability of being hospitalized due to diabetes presented the greatest impact on the model’s result.Conclusion: This study showed that using POC-A1c devices in primary care settings is a cost-effective alternative for monitoring glycated hemoglobin A1c as a marker of blood glucose control in people living with type 2 diabetes. According to our model, the use of POC-A1c device in a healthcare unit increased the early control of type 2 diabetes and, consequently, reduced the costs of diabetes-related outcomes, in comparison with a centralized laboratory test.

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“…Although the unit of POCT costs more than the conventional laboratory testing, the total reduction in the financial burden associated with POCT (including patient revisits, travel costs, work absence, and time saved) will reduce healthcare costs more than the laboratory testing [ 36 ]. According to a recently published German study [ 37 ], implementing POC for HbA1c testing in diabetes practices can enhance office processes and increase physician, staff, and patient satisfaction. It demonstrates a significant acceleration of evaluation processes as a result of fewer time-consuming blood samples, scheduling activities, and patient visits.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Patient Satisfaction with On-Site Point-of-Care Hemoglobin A1c Testing: An Observational Study

et al. 2021

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Introduction Poor glycemic control is a serious challenge in successful diabetes management. Given the low adherence and compliance with HbA1c testing frequency and the corresponding delay in the appropriate medication adjustment, point-of-care testing (POCT) for HbA1c provides an opportunity for better control of diabetes and higher patient satisfaction. The data with this regard are limited in Saudi Arabia. Therefore, we aimed to assess the level of patient satisfaction associated with the POCT service implementation for HbA1c and evaluate the differences between the number of requested and conducted HbA1c tests before and after POCT implementation and its effect on glycemic control in Saudi clinical practice. Methods We conducted a single-center ambispective descriptive cohort study in Riyadh, Saudi Arabia. This study had two phases: the retrospective phase (January 2017 to December 2017) and the prospective phase (January 2018 to December 2018). Patient satisfaction was assessed using the patient satisfaction questionnaire short form (PSQ-18) and on-site HbA1c point-of-care testing (HbA1c-POCT) satisfaction questionnaire. Results This study included 75 patients with diabetes (37% type 1, 63% type 2) with a mean age of 44.35 (± 17.97) years. The adherence to physician recommendations for HbA1c testing frequency increased from 24% to 85% (before and after POCT implementation, respectively). High levels of satisfaction across seven dimensions of PSQ-18 (77–88%) were reported towards the provided healthcare service after POCT implementation. Furthermore, a high level of agreement on the statements of the on-site HbA1c-POCT satisfaction questionnaire was also observed. Finally, the mean HbA1c level has significantly improved after POCT implementation compared to the traditional HbA1c laboratory testing before POCT implementation [8.34 ± 0.67 and 8.06 ± 0.62, respectively, p < 0.001). Conclusion HbA1c testing at POCT improved adherence to recommendations for HbA1c testing frequency for better glycemic control and higher patient satisfaction. POCT reduces turnaround time, improves glycemic control, and facilitates the decision-making process. HbA1c measurement with POC devices is recommended to be implemented in diabetes treatment centers. All of the described benefits of POCT come together to make HbA1c testing the most common procedure for diabetes management at the point of care. Supplementary Information The online version contains supplementary material available at 10.1007/s13300-021-01126-7.

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Implementation of HbA1c Point of Care Testing in 3 German Medical Practices: Impact on Workflow and Physician, Staff, and Patient Satisfaction

Abstract: The implementation of HbA1c POCT leads to an improved practice workflow and increases satisfaction of physicians, staff members and patients.

Cited by 16 publications

References 18 publications

Pandemic threatens primary care for long term conditions

Pandemic threatens primary care for long term conditions

Cost-Effectiveness of Point-of-Care A1C Tests in a Primary Care Setting

Assessment of Patient Satisfaction with On-Site Point-of-Care Hemoglobin A1c Testing: An Observational Study

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