Primary care and point-of-care testing during a pandemic: Clinician’s perspectives on integrating rapid testing for COVID-19 into the primary care pathway
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Abstract
Background
Real-world evidence to support the adoption of SARS-CoV-2 point-of-care (POC) tests in primary care is limited. As the first point of contact of the health system for most patients, POC testing can potentially support general practitioners (GPs) quickly identify infectious and non-infectious individuals to rapidly inform patient triaging, clinical management, and safely restore more in-person services.
Objectives
To explore the potential role of SARS-CoV-2 point-of-care testing in primary care services.
Design
A qualitative study using an inductive thematic analysis.
Setting
21 general practices located across three regions in England.
Results
Three major themes were identified related to POC test implementation in primary care: (1) Insights into SARS-CoV-2 POC tests; (2) System and organisational factors; and (3) Practice-level service delivery strategies. Thematic subcategories included involvement in rapid testing, knowledge and perception of the current POC testing landscape, capacity for testing, economic concerns, resource necessities, perception of personal risk and safety, responsibility for administering the test, and targeted testing strategies.
Conclusion
GPs knowledge of POC tests influences their degree of trust, uncertainty, and their perception of risk of POC test use. Concerns around funding, occupational exposure, and workload play a crucial role in GPs hesitation to provide POC testing services. These concerns could potentially be addressed with government funding, the use of targeted testing, and improved triaging strategies to limit testing to essential patient cohorts.
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SciScore for 10.1101/2021.04.13.21255347: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Consent: We obtained written, informed consent from all study participants.
IRB: The Newcastle University Faculty of Medical Sciences Research Ethics Committee reviewed the protocol and deemed the work exempt from ethical approval.Sex as a biological variable Data collection: Semi-structured interviews were conducted via videoconference between September and November 2020 by an experienced male qualitative researcher (PK) and three researchers (one male, two females) with training in qualitative methods (TH, YY, JA). Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also …
SciScore for 10.1101/2021.04.13.21255347: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Consent: We obtained written, informed consent from all study participants.
IRB: The Newcastle University Faculty of Medical Sciences Research Ethics Committee reviewed the protocol and deemed the work exempt from ethical approval.Sex as a biological variable Data collection: Semi-structured interviews were conducted via videoconference between September and November 2020 by an experienced male qualitative researcher (PK) and three researchers (one male, two females) with training in qualitative methods (TH, YY, JA). Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Strengths and Limitations: A strength was the qualitative methods we used. They allowed us to explore the views and experiences of general practice staff in an in-depth and descriptive manner. The topic guide was piloted with two GPs who were not participants in the study, with minimal changes recommended. Although the sample size was small, we achieved information saturation appropriate to a qualitative study design when no new themes were discovered during the interviews [22]. Concurrent thematic analysis ensured that data saturation occurred before data collection was complete. A limitation is that we included general practices from only three regions of England, which may not have captured the variation in clinical practice and might therefore limit the generalisability of findings. The interview participants did not include any nurses and HCAs, who are likely to have play a central part of POC use in primary care. Lastly, the interviews occurred between the 25th of September 2020 and the 27th of October when the COVID-19 situation in the UK was changing rapidly, immediately prior to the second national lockdown in November 2020. It is possible participants priorities may have changed subsequently.
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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