Point-of-care tests to manage acute respiratory tract infections in primary care: a systematic review and qualitative synthesis of healthcare professional and patient views.

IF 3.9 2区 医学 Q1 INFECTIOUS DISEASES Journal of Antimicrobial Chemotherapy Pub Date : 2024-10-08 DOI:10.1093/jac/dkae349
Melanie E Hoste, Aleksandra J Borek, Marta Santillo, Nia Roberts, Sarah Tonkin-Crine, Sibyl Anthierens
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Abstract

Objectives: To review the evidence on healthcare professionals' (HCPs) and patients' views of the use of point-of-care tests (POCTs) in the management of acute respiratory tract infections (RTIs) in primary care settings.

Methods: We conducted a systematic review of studies up to 28 April 2023. We included studies that included qualitative methods and results; focused on HCPs' and/or patients' views/experiences of POCTs for acute RTIs; and were conducted in primary care settings. We conducted a thematic synthesis to identify how their views on POCTs and interventions can support test use (PROSPERO registration: CRD42019150347).

Results: We included 33 studies, developing 9 categories each for HCP and patient data. We identified 38 factors affecting POCT use: 28 from HCPs and 10 from patients. Factors exist outside and within consultations, and post-consultations, illustrating that some cannot be addressed by HCPs alone. Fourteen interventions were identified that could address factors and support POCT use, with 7 interventions appearing to address the most factors. Some interventions were beyond the scope of HCPs and patients and needed to be addressed at system and organizational levels. Both groups had mixed views on the use of POCTs and highlighted implementation challenges.

Discussion: This review highlights numerous factors affecting POCT use in primary care. Policy-makers planning to implement POCTs are likely to achieve more by providing multi-faceted interventions that target factors outside, within, and post-consultation. Some interventions may need to be already established before POCT introduction. Whilst evidence beyond general practice is limited, similar factors suggest that similar context-tailored interventions would be appropriate.

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基层医疗机构管理急性呼吸道感染的床旁检测:对医护人员和患者观点的系统回顾和定性综述。
目的综述医护人员(HCPs)和患者对在基层医疗机构使用床旁检测(POCTs)治疗急性呼吸道感染(RTIs)的看法:我们对截至 2023 年 4 月 28 日的研究进行了系统回顾。我们纳入了包含定性方法和结果的研究;这些研究关注的是初级保健人员和/或患者对急性 RTI POCT 的看法/体验;这些研究是在初级保健环境中进行的。我们进行了专题综述,以确定他们对 POCT 和干预措施的看法如何支持检测的使用(PROSPERO 注册:CRD42019150347):我们纳入了 33 项研究,为 HCP 和患者数据各制定了 9 个类别。我们确定了 38 个影响 POCT 使用的因素:其中 28 项来自 HCP,10 项来自患者。这些因素既存在于会诊之外,也存在于会诊之内和会诊之后,说明有些因素仅靠医疗保健人员是无法解决的。已确定 14 项干预措施可解决各种因素并支持 POCT 的使用,其中 7 项干预措施似乎可解决最多的因素。有些干预措施超出了保健医生和患者的能力范围,需要在系统和组织层面加以解决。两组人员对使用 POCT 的看法不一,并强调了实施方面的挑战:本综述强调了影响 POCT 在初级保健中使用的诸多因素。计划实施 POCT 的政策制定者可能会通过提供针对诊疗外、诊疗内和诊疗后因素的多方面干预措施来取得更大的成果。有些干预措施可能需要在引入 POCT 之前就已确立。虽然全科医生以外的证据有限,但类似的因素表明,根据具体情况采取类似的干预措施也是合适的。
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来源期刊
CiteScore
9.20
自引率
5.80%
发文量
423
审稿时长
2-4 weeks
期刊介绍: The Journal publishes articles that further knowledge and advance the science and application of antimicrobial chemotherapy with antibiotics and antifungal, antiviral and antiprotozoal agents. The Journal publishes primarily in human medicine, and articles in veterinary medicine likely to have an impact on global health.
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