Since 2004, the Flinders University International Centre for Point-of-Care Testing has assisted the Mallee Track Health & Community Service with a point-of-care testing (POCT) service for diabetes management in rural Australia. The POCT devices originally implemented were the DCA 2000 (hemoglobin A1c) and the Cholestech (glucose, lipids). In recent years, new options for POCT have become available, including the DCA Vantage (hemoglobin A1c), the StatStrip (glucose), and the Piccolo (glucose, lipids). The analytical performance of the POCT devices was evaluated using a patient comparison study (n = 103) to measure accuracy and using on-site quality control testing to measure between-day imprecision. Stakeholder satisfaction was assessed using questionnaires for patients with diabetes (n = 60) and focus interviews with the POCT operator and general practitioner. The DCAVantage and Piccolo exhibited sound analytical performance. A statistically significant improvement in satisfaction with the new devices was reported by the patients (Fisher exact probability, P < 0.05). All stakeholders showed high levels of satisfaction with POCT in terms of convenience, acceptability, and confidence in test results. This study supports the effective use of POCT in rural general practice settings for diabetes management.D iabetes mellitus is a major health problem reaching epidemic proportions in many parts of the world. 1 There were approximately 371 million people living with diabetes worldwide in 2012, constituting 8.3% of the world's adult population. 2 In Australia, there are more than 1.7 million people living with diabetes, with prevalence set to double by 2025. 3,4 Diabetes causes significant morbidity and mortality, primarily from cardiovascular complications, renal and eye disease, and limb amputations. 5 In addition to the impact on the health of individuals with the disease, diabetes causes significant economic impact on individuals, families, health systems, and countries across the world. 6 Pathology testing plays a vital role in managing patients with diabetes and monitoring of complications of the disease. Pathology tests performed as part of a patient's diabetes review include glucose, hemoglobin A1c (HbA1c), urine albumin-creatinine ratio (ACR), and lipids (total cholesterol, high-and low-density lipoprotein [HDL and LDL] cholesterol, and triglyceride). 7,8 These tests can now be performed safely and effectively through pointof-care testing (POCT). Point-of-care testing is pathology testing performed in a clinical setting at the time of patient consultation.convenience, acceptability, and confidence in test results. Overall, the GP and the POCT operator were very satisfied with all aspects of the new POCT service.
Limitations of This StudyOnly 1 POCT operator and 1 GP took part in this project, which meant that their satisfaction levels could not be statistically analyzed. Nonetheless, this staffing structure reflected the "realtime" nature of workflow within the MTH&CS clinic.Owing to the nature of this project f...