Abstract
Background: Patient preparation is one of the least standardized parts of the preanalytic phase oftesting. Fasting blood glucose requires fasting for 8-12 hours as per various guidelines and also hasseveral other requirements. Lack of communication, understanding, or compliance regarding hours-of-fasting, water-intake, avoidance of caloric snack/beverage, the sudden change in smoking,exercise, alcohol, medication, etc. introduces preanalytic errors. Method: To evaluate awareness,understanding, and compliance with fasting requirements, a face-to-face survey was done onoutpatients in a Government Hospital in Pali, Rajasthan, India. Relatively more educated internetusers were surveyed as controls through an online SurveyMonkey tool. Results: 98 patients and187 controls participated in the study. Perception about fasting requirements ranged from 0-17hours. 71% of patients and 35% of controls perceived that nobody explained to them the durationor nature of fasting. The different sources of information had been used in different proportions bypatients and controls. For imparting understanding and compliance about duration, and otherrequirements of fasting, the instruction was usually incomplete but still much more effective (p-value=0.000002) than formal education level (p-value=0.024). Conclusion: 71% of patients and35% of controls did not receive instructions for fasting. 40% of those instructed showed bettercompliance, but awareness was incomplete. The instruction was more effective than formaleducation in improving awareness and compliance. Improved awareness was strongly associatedwith receiving instruction and weakly associated with formal education but financial status showedonly a weak negative association.
Highlights
The preanalytic phase, i.e. the series of steps before the actual testing of a laboratory investigation, is known to incur significantly more errors (50-70%) than the analytic (5-15%) and the post-analytic phases (10-30%) [1]
Fasting blood glucose requires fasting for 8-12 hours as per various guidelines and has several other requirements
Improved awareness was strongly associated with receiving instruction and weakly associated with formal education but financial status showed only a weak negative association
Summary
The preanalytic phase, i.e. the series of steps before the actual testing of a laboratory investigation, is known to incur significantly more errors (50-70%) than the analytic (5-15%) and the post-analytic phases (10-30%) [1]. A problematic area of the preanalytic phase involves those requiring patient preparation [3]. Fasting is the most well-known type of patient preparation for diagnostic medical testing. [4,5,6,7] it is glucose for which fasting measurement is most common patient preparation asked by a medical laboratory. Patient preparation is one of the least standardized parts of the preanalytic phase of testing. For imparting understanding and compliance about duration, and other requirements of fasting, the instruction was usually incomplete but still much more effective (pvalue=0.000002) than formal education level (p-value=0.024). The instruction was more effective than formal education in improving awareness and compliance. Improved awareness was strongly associated with receiving instruction and weakly associated with formal education but financial status showed only a weak negative association
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