Exploration of clinical and ethical issues in an expanded newborn metabolic screening programme: a qualitative interview study of healthcare professionals in Hong Kong.

IF 3.1 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Hong Kong Medical Journal Pub Date : 2024-04-01 Epub Date: 2024-04-09 DOI:10.12809/hkmj2210234
O M Y Ngan, C J Tam, C K Li
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Abstract

Introduction: The Newborn Screening Programme for Inborn Errors of Metabolism (NBSIEM) enables early intervention and prevents premature mortality. Residual dried bloodspots (rDBS) from the heel prick test are a valuable resource for research. However, there is minimal data regarding how stakeholders in Hong Kong view the retention and secondary use of rDBS. This study aimed to explore views of the NBSIEM and the factors associated with retention and secondary use of rDBS among healthcare professionals in Hong Kong.

Methods: Between August 2021 and January 2022, semi-structured interviews were conducted with 30 healthcare professionals in obstetrics, paediatrics, and chemical pathology. Key themes were identified through thematic analysis, including views towards the current NBSIEM and the retention and secondary use of rDBS.

Results: After implementation of the NBSIEM, participants observed fewer patients with acute decompensation due to undiagnosed inborn errors of metabolism. The most frequently cited clinical utilities were early detection and improved health outcomes. Barriers to rDBS storage and its secondary use included uncertain value and benefits, trust concerns, and consent issues.

Conclusion: This study highlighted healthcare professionals' concerns about the NBSIEM and uncertainties regarding the handling or utilisation of rDBS. Policymakers should consider these concerns when establishing new guidelines.

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探讨扩大新生儿代谢筛查计划中的临床和伦理问题:对香港医护人员的定性访谈研究。
导言:新生儿先天性代谢异常筛查计划(NBSIEM)有助于早期干预和预防过早死亡。刺足跟试验的残留干血点(rDBS)是一项宝贵的研究资源。然而,有关香港相关人士如何看待残留干血点的保留和二次利用的数据却少之又少。本研究旨在探讨香港医护人员对NBSIEM的看法以及保留和二次使用rDBS的相关因素:在 2021 年 8 月至 2022 年 1 月期间,我们对产科、儿科和化学病理科的 30 名专业医护人员进行了半结构化访谈。通过主题分析确定了关键主题,包括对现行 NBSIEM 以及保留和二次使用 rDBS 的看法:结果:在实施 NBSIEM 后,参与者发现因未确诊的先天性代谢异常而导致急性失代偿的患者减少了。最常提及的临床效用是早期发现和改善健康状况。rDBS储存和二次使用的障碍包括价值和益处不确定、信任问题和同意问题:本研究强调了医疗保健专业人员对 NBSIEM 的担忧以及在处理或使用 rDBS 方面的不确定性。政策制定者在制定新指南时应考虑这些问题。
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来源期刊
Hong Kong Medical Journal
Hong Kong Medical Journal MEDICINE, GENERAL & INTERNAL-
CiteScore
1.50
自引率
14.80%
发文量
117
审稿时长
10 weeks
期刊介绍: The HKMJ is a Hong Kong-based, peer-reviewed, general medical journal which is circulated to 6000 readers, including all members of the HKMA and Fellows of the HKAM. The HKMJ publishes original research papers, review articles, medical practice papers, case reports, editorials, commentaries, book reviews, and letters to the Editor. Topics of interest include all subjects that relate to clinical practice and research in all branches of medicine. The HKMJ welcomes manuscripts from authors, but usually solicits reviews. Proposals for review papers can be sent to the Managing Editor directly. Please refer to the contact information of the Editorial Office.
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