Barriers, enablers, benefits, and drawbacks to Point of Care Testing (POCT) : a survey of the General Practice Out-of-Hours (GPOOH) Service in Scotland

Abstract

Background The GP Out-of-Hours Service (GPOOH) is under pressure to treat more patients, in less time, while reducing referrals and minimising diagnostic errors. Point-of-Care Tests (POCT) are rapid clinical tests that can be used to generate results during the consultation, and have the potential to facilitate managing these competing demands safely. Aim Describe current availability of POCTs in GPOOH in Scotland, and identify barriers, enablers, benefits, and drawbacks to their use. Design & setting Electronic questionnaire developed, designed piloted, and distributed to clinicians in GPOOH in NHS Scotland. Method Cross-sectional mixed-methods study with closed questions and free text. Results 142 responses received. Urine dipstick testing (99.2%), pregnancy tests (98.5%), oxygen saturation (97.7%) and blood glucose testing (93.9%), were the only commonly available in GPOOH in NHS Scotland. There was strongest support for the provision of POCTs, particularly CRP (79.4%), Streptococcus A (76.0%), and D-dimer (75.2%). Respondents felt that POCTs would improve confidence (92.3%) and safety (89.8%) surrounding clinical decision-making, improve patient satisfaction (80.6%), and reduce hospital and secondary care referrals (77.5%). Barriers to POCT use were availability of the test kits and machines (94.5%), training requirements on how to use the machine (71.1%) and interpret results (56.3%) and time to do the test (62.0%). Conclusions Very few POCTs are in regular use in GPOOH in Scotland. GPOOH clinicians are supportive of using POCTs. They identified a number of benefits to their use, with very few drawbacks. Increased provision of POCTs in GPOOH in NHS Scotland should be considered urgently.