Utilisation and consequences of CRP point-of-care-testing in primary care practices: a real-world multicentre observational study with 1740 patient cases in Germany.

Abstract

Background: C-reactive protein point-of-care tests (CRP-POCTs) can support GPs' clinical decision making but they are not widely used in German general practices.

Aim: To investigate the utilisation of semi-quantitative CRP-POCTs in routine primary care.

Design & setting: Prospective observational study in 49 general practices in Germany (from November 2022-April 2023).

Method: GPs were provided with CRP-POCTs and collected data for each CRP-POCT use, with standardised data-collection sheets.

Results: Data from 1740 CRP-POCT uses were recorded. GPs employed CRP-POCTs mainly for patients with respiratory tract infections (RTIs; 71.2% of all cases) and to a lesser extent for gastrointestinal infections (GIs; 10.4%). In RTIs, CRP-POCTs were frequently used to distinguish between bacterial and viral aetiology (60.8%) and to guide decisions on antibiotic prescribing (62.8%). In GIs, CRP-POCTs were mainly used to rule out severe disease progressions (53.2%) and for decisions on further diagnostic procedures (45.6%). In RTIs, CRP-POCTs influenced antibiotic prescribing in 77.5% of the cases (32.3% in favour versus 45.2% waiver). In GIs, CRP levels mainly affected decisions on further diagnostic procedures. GPs reported that CRP-POCTs were helpful in 88.6% of all cases.

Conclusion: When available, German GPs predominantly use semi-quantitative CRP-POCTs to guide decisions on antibiotic prescribing in patients with RTIs. CRP-POCT use improves clinical decision making and increases the GP's clinical confidence.