Point-of-Care Testing of COVID-19: Current Status, Clinical Impact, and Future Therapeutic Perspectives

Gangula, Abilash; Kim, Brandon; Casey, Benjamin; Hamill, Allison; Regunath, Hariharan; Upendran, Anandhi

doi:10.1007/978-981-19-4957-9_1

Cited by 3 publications

(3 citation statements)

References 211 publications

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“…Since it is likely that multiple countries will have to go through this scenario again, alternative testing set-ups have been considered. In order to lighten the socioeconomic and organizational burden of the healthcare system and patients, implementing PCR testing in general practices could be a potentially successful alternative in future pandemic situations, as well as an overall improvement of diagnostics (2).…”

Section: Trial Registration N/amentioning

confidence: 99%

“…strep A antigen and C-Reactive Protein (CRP) testing has been the traditional standard procedure for examining patients with acute respiratory tract infections (RTI) in primary care. Recently, there has been an increasing interest in adding Point-of-care PCR testing for infectious diseases as a standard procedure, since it may not only save time spent for each patient compared to usual PCR testing with specimens sent to a laboratory, but also offer the possibility of diagnosing other infectious agents than current POC tests (2). Cobas® Liat® is a PCR tester developed for rapid testing in case of upper Implementing new technology in health care organizations can be challenging, and studying how new technology is imbedded in clinical practice and how professionals experience the potential added value is important to policymaking.…”

Section: Trial Registration N/amentioning

confidence: 99%

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Implementing PCR testing in general practice – a qualitative study using normalization process theory

Shahrzad

Balasubramaniam

Kousgaard

et al. 2023

Preprint

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Background The covid-19 pandemic brought attention to a need of rapid testing of large populations. Experiences from community-based testing settings show that there can be workload difficulties, logistical challenges, and socioeconomic downsides to large scale Polymerase Chain Reaction (PCR) testing. Alternative testing arenas have therefore been considered. Rapid point-of-care (POC) PCR test methods have since been developed and could have potential to surveille respiratory viral infections. It is, however, unknown if PCR testing can be successfully implemented routinely in general practice. The aim of this study is therefore to asses factors that enable and inhibit the implementation of point-of-care PCR testing for acute respiratory tract infection in general practice. Methods Fourteen general practices in the east Zealand area in Denmark were included in the study and given access to point-of-care PCR testing equipment during a flu season. The participating clinics were initially trained in the use of a POC PCR testing device and then spent 6 weeks testing it. We conducted qualitative interviews with general practitioners (GPs) and their staff, before and after the testing period, specifically focusing on their clinical decision-making and internal collaboration in relation to POC PCR testing. We used normalization process theory to design the interview guides and to analyze the data. Results Professionals reported no clinical need for a POC PCR testing device in a non-pandemic clinical setting. Results were delivered faster, but this was only timesaving for the patient and not the GP, who had to perform more tasks. Conclusion In its current form, the added diagnostic value of using a POC PCR tester in clinical practice does not justify the increased work connected to the usage of the diagnostic procedure in daily practice. Trial registration n/a

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Section: Trial Registration N/amentioning

confidence: 99%

Section: Trial Registration N/amentioning

confidence: 99%

Implementing PCR testing in general practice – a qualitative study using normalization process theory

Shahrzad

Balasubramaniam

Kousgaard

et al. 2023

Preprint

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“…These studies illustrated that technology design, stakeholder engagement, and sufficient evidence on utility aid adoption. In addition, the COVID-19 pandemic has triggered public recognition and investment in POCTs ( 15 , 16 ) which may influence adoption of other tests. This study examines European stakeholders’ views and experiences of implementing novel POCTs in primary care, and their views on the impact of the COVID-19 pandemic in this area.…”

Section: Introductionmentioning

confidence: 99%

Stakeholders’ views and experiences on implementing new diagnostics in primary care to support management of community-acquired acute respiratory tract infections: a qualitative study

Hoste,

Colman,

Wanat

et al. 2023

Front. Public Health

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BackgroundThe majority of antibiotics are prescribed in primary care for respiratory tract infections. Point-of-care tests (POCTs) for the management of community-acquired acute respiratory tract infections (CA-ARTI) have been developed to help optimize antibiotic prescribing. While some countries in Europe have adopted these tests in primary care settings, most have not. Stakeholders, such as policy-makers, regulators, the diagnostic industry, and scientific associations, have roles in the implementation of new diagnostics in primary care. The aim of this study is to explore these stakeholders’ views and experiences, and identify areas of unmet need relating to POCT implementation.MethodsStakeholders were recruited using purposive sampling and snowballing. Between March 2021 and May 2022, semi-structured interviews were conducted online with stakeholders in Belgium, the UK and from European Union (EU) -level organizations. Interviews were audio recorded and transcribed verbatim. Transcripts were analysed inductively and deductively using thematic analysis.ResultsTwenty-six stakeholders participated: eleven from EU-level organizations, seven from Belgium, and eight from the UK. Five themes were identified. Stakeholders felt a balance of top-down and bottom-up approaches were an optimal strategy to the implementation of POCTs. Stakeholders stressed the need to engage with clinicians to act as champions for tests to help raise awareness and generate new evidence on how tests are used. While acknowledging the potential of POCTs for improving patient outcomes and impacting antibiotic prescribing behavior, some raised concerns on how tests would be used in practice and wished to see national data on effectiveness. COVID-19 catalyzed the use of tests, but stakeholders were pessimistic that processes for approving diagnostics during the pandemic would be replicated in the future.ConclusionStakeholders provided recommendations for research and practice. Robust reimbursement policies could alleviate financial burden from clinicians and patients, encouraging practices to adopt POCTs. Industry is likely to benefit from engaging as early on as possible with other stakeholders. Due to uncertainty among stakeholders on the impact of POCTs on antibiotic prescribing, further evidence is needed to understand how practices adopt POCTs and the implications for stewardship. Monitoring how POCTs are used can inform future guidelines on successful diagnostic implementation.

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Implementing PCR testing in general practice—a qualitative study using normalization process theory

Shahrzad,

Balasubramaniam,

Kousgaard

et al. 2023

BMC Health Serv Res

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Background The COVID-19 pandemic brought attention to a need for rapid testing of large populations. Experiences from community-based testing settings show that there can be workload difficulties, logistical challenges and socioeconomic downsides to large scale Polymerase Chain Reaction (PCR) testing. Alternative testing arenas have therefore been considered. Rapid point-of-care (POC) PCR test methods have since been developed and could have potential to surveille viral respiratory infections. It is, however, unknown if PCR testing can be successfully implemented routinely in general practice. The aim of this study was to assess factors that enable and inhibit the implementation of point-of-care PCR testing for acute respiratory tract infection in general practice. Methods Fourteen general practices in the east Zealand area in Denmark were included in the study and given access to POC PCR testing equipment during a flu season. The participating clinics were initially trained in the use of a POC PCR testing device and then spent 6 weeks testing it. We conducted qualitative interviews with general practitioners (GPs) and their staff, before and after the testing period, specifically focusing on their clinical decision-making and internal collaboration in relation to POC PCR testing. We used normalization process theory to design the interview guides and to analyze the data. Results Professionals reported no clinical need for a POC PCR testing device in a non-pandemic clinical setting. Results were delivered faster, but this was only timesaving for the patient and not the GP, who had to perform more tasks. Conclusion In its current form, the added diagnostic value of using POC PCR testing in general practice was not sufficient for the professionals to justify the increased work connected to the usage of the diagnostic procedure in daily practice. Trial registration n/a.

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Point-of-Care Testing of COVID-19: Current Status, Clinical Impact, and Future Therapeutic Perspectives

Cited by 3 publications

References 211 publications

Implementing PCR testing in general practice – a qualitative study using normalization process theory

Implementing PCR testing in general practice – a qualitative study using normalization process theory

Stakeholders’ views and experiences on implementing new diagnostics in primary care to support management of community-acquired acute respiratory tract infections: a qualitative study

Implementing PCR testing in general practice—a qualitative study using normalization process theory

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