Stakeholders’ views and experiences on implementing new diagnostics in primary care to support management of community-acquired acute respiratory tract infections: a qualitative study

Frontiers in Public Health

Public Health

Elien Colman¹  Sibyl Anthierens¹  Melanie Eugenie Hoste²  Herman Goossens³  Gail Hayward⁴  Sarah Tonkin-Crine⁴  Marta Wanat⁴  Maarten Postma⁵  Jean-Louis Tissier⁶ 

[1] Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium;Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium;Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium;Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium;Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom;Unit of Global Health, Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands;bioMérieux, Marcy l’Etoile, France;

关键词: point-of-care testing;    respiratory tract infections;    qualitative;    primary care;    antibiotic prescribing;    stakeholder;    Europe;   

DOI  :  10.3389/fpubh.2023.1216940

 received in 2023-05-04, accepted in 2023-07-06,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundThe majority of antibiotics are prescribed in primary care for respiratory tract infections. Point-of-care tests (POCTs) for the management of community-acquired acute respiratory tract infections (CA-ARTI) have been developed to help optimize antibiotic prescribing. While some countries in Europe have adopted these tests in primary care settings, most have not. Stakeholders, such as policy-makers, regulators, the diagnostic industry, and scientific associations, have roles in the implementation of new diagnostics in primary care. The aim of this study is to explore these stakeholders’ views and experiences, and identify areas of unmet need relating to POCT implementation.MethodsStakeholders were recruited using purposive sampling and snowballing. Between March 2021 and May 2022, semi-structured interviews were conducted online with stakeholders in Belgium, the UK and from European Union (EU) -level organizations. Interviews were audio recorded and transcribed verbatim. Transcripts were analysed inductively and deductively using thematic analysis.ResultsTwenty-six stakeholders participated: eleven from EU-level organizations, seven from Belgium, and eight from the UK. Five themes were identified. Stakeholders felt a balance of top-down and bottom-up approaches were an optimal strategy to the implementation of POCTs. Stakeholders stressed the need to engage with clinicians to act as champions for tests to help raise awareness and generate new evidence on how tests are used. While acknowledging the potential of POCTs for improving patient outcomes and impacting antibiotic prescribing behavior, some raised concerns on how tests would be used in practice and wished to see national data on effectiveness. COVID-19 catalyzed the use of tests, but stakeholders were pessimistic that processes for approving diagnostics during the pandemic would be replicated in the future.ConclusionStakeholders provided recommendations for research and practice. Robust reimbursement policies could alleviate financial burden from clinicians and patients, encouraging practices to adopt POCTs. Industry is likely to benefit from engaging as early on as possible with other stakeholders. Due to uncertainty among stakeholders on the impact of POCTs on antibiotic prescribing, further evidence is needed to understand how practices adopt POCTs and the implications for stewardship. Monitoring how POCTs are used can inform future guidelines on successful diagnostic implementation.

【 授权许可】

Unknown   
Copyright © 2023 Hoste, Colman, Wanat, Hayward, Tissier, Postma, Goossens, Anthierens and Tonkin-Crine on behalf of the VALUE-Dx study team.