Point-of-care testing among general practitioners, a cross-sectional study

Angelika Sandholzer-Yilmaz, Ricarda Oehme, Thomas Frese, Marcus Heise, Thomas Fankhaenel

Keywords: point-of-care-testing, general practice, utilitsation, estimated usefulness, Germany

Point-of-care testing (POCT) has numerous potential benefits to improve health care service, especially in resource-limited settings.

Research questions:
We aim to identify which POC-tests (POCTs) are known, utilized, and rated as useful by general practitioners (GPs) .

Methods: A questionnaire with 27 POCTs was posted to a haphazard selection of GPs (n=451) in Saxony, Germany.

A total of 208 GPs replied (response rate 46.1%). Out of 27 POCTs, each GP knew an average of 20.3 as laboratory parameters and 9.2 as POCTs. Urine test strips (99.0%), blood glucose test (98.1%), and Troponin I/T (86.4%) were the best known, followed by INR/Quick (82.5%), Microalbumin (79.1%), and D-dimer (78.6%) POCTs. Yet, solely 0 to 13 POC tests were actually used (mean value 4.6). Urine test strips were employed most frequently (97.6%), followed by blood glucose test (94.7%), Troponin I/T (57.8%), Microalbumin (57.3%), and INR/Quick POCTs (41.7%). Heart fatty binding protein (H-FABP), Syphilis, Coeliac disease, and Malaria appeared as the least frequently used POCTs. The majority of the GPs declared eleven of the 27 POCTs to be useful.

The most recurrently employed POCTs are those for diagnosing or monitoring diabetes mellitus, ensued by POCTs addressing acute cardiovascular diseases (Troponin I/T, D-dimer) or monitoring the therapy of infectious diseases or the anticoagulant therapy. POCTs most often rated as useful by GPs are also widely known and frequently used. Nonetheless, the majority of GPs rate only a very limited number of POCTs as useful. Frequent concerns might be low economic benefit, over-reliance, and test accuracy coming along with the complex implementation of the tests requiring technical skills, accurate storage, and the correct interpretation of test results.

Points for discussion:
Implication for further reasearch

Implications for improving control of chronic diseases in general practice through POCT-testing