Abstract
BackgroundPoint-of-care tests (POCTs) are increasingly used in family medicine clinics in the United States. While the diagnostics industry predicts significant growth in the number and scope of POCTs deployed, little is known about clinic-level attitudes towards implementation of these tests. We aimed to explore attitudes of primary care providers, laboratory and clinic administrative/support staff to identify barriers and facilitators to use of POCTs in family medicine.MethodsSeven focus groups and four semi-structured interviews were conducted with a total of 52 clinic staff from three family medicine clinics in two US states. Qualitative data from this exploratory study was analyzed using the constant comparison method.ResultsFive themes were identified which included the impact of POCTs on clinical decision-making; perceived inaccuracy of POCTs; impact of POCTs on staff and workflow; perceived patient experience and patient-provider relationship, and issues related to cost, regulation and quality control. Overall, there were mixed attitudes towards use of POCTs. Participants believed the added data provided by POCT may facilitate prompt clinical management, diagnostic certainty and patient-provider communication.Perceived barriers included inaccuracy of POCT, shortage of clinic staff to support more testing, and uncertainty about their cost-effectiveness.ConclusionsThe potential benefits of using POCTs in family medicine clinics are countered by several barriers. Clinical utility of many POCTs will depend on the extent to which these barriers are addressed. Engagement between clinical researchers, industry, health insurers and the primary care community is important to ensure that POCTs align with clinic and patient needs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-016-0549-1) contains supplementary material, which is available to authorized users.
Highlights
Point-of-care tests (POCTs) are increasingly used in family medicine clinics in the United States
We identified and included three primary care clinics in the WWAMI region Practice and Research Network (WPRN); a practice-based research network in the 5-state Washington, Wyoming, Alaska, Montana and Idaho (WWAMI) area comprising over 50 family medicine clinics
Research sites were selected based on our desire to include clinics with a range of characteristics such as location and type, and to include clinics serving populations with varied clinical needs and diverse experiences of POCTs
Summary
Point-of-care tests (POCTs) are increasingly used in family medicine clinics in the United States. Most family medicine clinics in the US have a small on-site laboratory, which provides facilities to undertake diagnostic tests (including POCTs) categorized by the US Food and Drug Administration (FDA) as being of low complexity to implement and interpret (referred to as CLIA-waivered tests) [3]. These laboratories conduct tests such as Rapid Group A Streptococcus antigen tests or dipstick urine tests, as well as obtain specimen samples for sending to external laboratories for more complex testing. This contrasts with POCTs undertaken in countries such as the United Kingdom that are mostly done in the physician’s office by the physician [6]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
