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

A qualitative study

Bibliographic Data

ID22078480
AuthorsMelanie Eugenie Hoste (0000-0003-0831-3354, University of Antwerp), Elien Colman (0000-0001-7819-8027, University of Antwerp), Marta Wanat (0000-0002-0163-1547, University of Oxford), Gail Hayward (0000-0003-0852-627X, University of Oxford), Jean-Louis Tissier (bioMérieux (France)), Maarten J Postma (0000-0002-6306-3653, University Medical Center Groningen), Maarten Postma, Herman Goossens (0000-0002-6712-2796, University of Antwerp), Sibyl Anthieren (0000-0003-4762-1907, University of Antwerp), Sibyl Anthierens, Sarah Tonkin-Crine (0000-0003-4470-1151, University of Oxford), on behalf of the VALUE-Dx study team (University Medical Center Groningen)
Year2023
Volume11
Pages1216940-1216940
Publication date2023-07-31
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2023.1216940
PMID37583883
OpenAlexW4385410794
LanguageEN
References cited28

Background: The 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. Methods: Stakeholders 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. Results: Twenty-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. Conclusion: Stakeholders 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

Business · Environmental health · European union · Family medicine · Nonprobability sampling · Qualitative research · Respiratory tract infections · Thematic analysis · Antibiotic Use and Resistance · Medicine · Nursing · Pneumonia and Respiratory Infections · Respiratory viral infections research · Internal Medicine

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