Current and future use of point-of-care tests in primary care: an international survey in Australia, Belgium, The Netherlands, the UK and the USA

Jeremy Howick; Jochen W L Cals; Caroline Jones; Christopher P Price; Annette Plüddemann; Carl Heneghan; Marjolein Y Berger; Frank Buntinx; John Hickner; Wilson Pace; Tony Badrick; Ann Van den Bruel; Caroline Laurence; Henk C van Weert; Evie van Severen; Adriana Parrella; Matthew Thompson

doi:10.1136/bmjopen-2014-005611

Current and future use of point-of-care tests in primary care: an international survey in Australia, Belgium, The Netherlands, the UK and the USA

BMJ Open. 2014 Aug 8;4(8):e005611. doi: 10.1136/bmjopen-2014-005611.

Authors

Jeremy Howick¹, Jochen W L Cals², Caroline Jones¹, Christopher P Price¹, Annette Plüddemann¹, Carl Heneghan¹, Marjolein Y Berger³, Frank Buntinx⁴, John Hickner⁵, Wilson Pace⁶, Tony Badrick⁷, Ann Van den Bruel¹, Caroline Laurence⁸, Henk C van Weert⁹, Evie van Severen¹⁰, Adriana Parrella⁸, Matthew Thompson¹¹

Affiliations

¹ Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
² Deptartment of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
³ Department of General Practice, University of Groningen, Groningen, The Netherlands.
⁴ Deptartment of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands Academic Center for General Practice, Leuven, Belgium.
⁵ Family Medicine, University of Illinois at Chicago, Chicago, Illinois, USA.
⁶ Department of Family Medicine, University of Colorado, Aurora, Colorado, USA.
⁷ Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia.
⁸ Discipline of General Practice, The University of Adelaide, Adelaide, South Australia, Australia.
⁹ Department of General Practice, University of Amsterdam, Amsterdam, The Netherlands.
¹⁰ Academic Center for General Practice, Leuven, Belgium.
¹¹ Department of Family Medicine, University of Washington, Seattle, Washington, USA.

Abstract

Objective: Despite the growing number of point-of-care (POC) tests available, little research has assessed primary care clinician need for such tests. We therefore aimed to determine which POC tests they actually use or would like to use (if not currently available in their practice).

Design: Cross-sectional survey.

Setting: Primary care in Australia, Belgium (Flanders region only), the Netherlands, the UK and the USA.

Participants: Primary care doctors (general practitioners, family physicians).

Main measures: We asked respondents to (1) identify conditions for which a POC test could help inform diagnosis, (2) from a list of tests provided: evaluate which POC tests they currently use (and how frequently) and (3) determine which tests (from that same list) they would like to use in the future (and how frequently).

Results: 2770 primary care clinicians across five countries responded. Respondents in all countries wanted POC tests to help them diagnose acute conditions (infections, acute cardiac disease, pulmonary embolism/deep vein thrombosis), and some chronic conditions (diabetes, anaemia). Based on the list of POC tests provided, the most common tests currently used were: urine pregnancy, urine leucocytes or nitrite and blood glucose. The most commonly reported tests respondents expressed a wish to use in the future were: D-dimer, troponin and chlamydia. The UK and the USA reported a higher actual and desired use for POC tests than Australia, Belgium and the Netherlands. Our limited data suggest (but do not confirm) representativeness.

Conclusions: Primary care clinicians in all five countries expressed a desire for POC tests to help them diagnose a range of acute and chronic conditions. Rates of current reported use and desired future use were generally high for a small selection of POC tests, but varied across countries. Future research is warranted to explore how specific POC tests might improve primary care.

Keywords: Chemical Pathology; Epidemiology; General Medicine (see Internal Medicine).

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Australia
Belgium
Clinical Laboratory Techniques / statistics & numerical data
Clinical Laboratory Techniques / trends*
Data Collection
Female
Humans
Male
Middle Aged
Netherlands
Point-of-Care Systems / statistics & numerical data
Point-of-Care Systems / trends*
Primary Health Care / statistics & numerical data
Primary Health Care / trends*
United Kingdom
United States