Impact of deploying multiple point-of-care tests with a ‘sample first’ approach on a sexual health clinical care pathway. A service evaluation
| العنوان: | Impact of deploying multiple point-of-care tests with a ‘sample first’ approach on a sexual health clinical care pathway. A service evaluation |
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| المؤلفون: | Aseel Hegazi, Catherine M Lowndes, Marcus Pond, Anthony Nardone, Emma M. Harding-Esch, S Tariq Sadiq, Phillip Hay, Olanike Okolo, Achyuta V Nori |
| المصدر: | Sexually Transmitted Infections |
| بيانات النشر: | BMJ, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Male, 0301 basic medicine, Cost-Benefit Analysis, Gonorrhea, Ambulatory Care Facilities, CLINICAL STI CARE, 0302 clinical medicine, Clinical pathway, London, 030212 general & internal medicine, TRICHOMONAS, GeneXpert MTB/RIF, Vaginosis, Bacterial, 3. Good health, Reproductive Health, Infectious Diseases, Female, Bacterial vaginosis, Trichomonas Vaginitis, Nucleic Acid Amplification Techniques, Adult, medicine.medical_specialty, SERVICE DELIVERY, Sexual health clinic, Point-of-Care Systems, Sexual Behavior, Point-of-care testing, 030106 microbiology, Dermatology, DIAGNOSIS, Clinical, 03 medical and health sciences, Internal medicine, medicine, Humans, Urethritis, business.industry, Reproducibility of Results, Nucleic acid amplification technique, Chlamydia Infections, Patient Acceptance of Health Care, medicine.disease, BACTERIAL INFECTION, Surgery, Patient Outcome Assessment, Feasibility Studies, business, Program Evaluation |
| الوصف: | OBJECTIVES: To assess clinical service value of STI point-of-care test (POCT) use in a 'sample first' clinical pathway (patients providing samples on arrival at clinic, before clinician consultation). Specific outcomes were: patient acceptability; whether a rapid nucleic acid amplification test (NAAT) for Chlamydia trachomatis/Neisseria gonorrhoeae (CT/NG) could be used as a POCT in practice; feasibility of non-NAAT POCT implementation for Trichomonas vaginalis (TV) and bacterial vaginosis (BV); impact on patient diagnosis and treatment. METHODS: Service evaluation in a south London sexual health clinic. Symptomatic female and male patients and sexual contacts of CT/NG-positive individuals provided samples for diagnostic testing on clinic arrival, prior to clinical consultation. Tests included routine culture and microscopy; CT/NG (GeneXpert) NAAT; non-NAAT POCTs for TV and BV. RESULTS: All 70 (35 males, 35 females) patients approached participated. The 'sample first' pathway was acceptable, with >90% reporting they were happy to give samples on arrival and receive results in the same visit. Non-NAAT POCT results were available for all patients prior to leaving clinic; rapid CT/NG results were available for only 21.4% (15/70; 5 males, 10 females) of patients prior to leaving clinic. Known negative CT/NG results led to two females avoiding presumptive treatment, and one male receiving treatment directed at possible Mycoplasma genitalium infection causing non-gonococcal urethritis. Non-NAAT POCTs detected more positives than routine microscopy (TV 3 vs 2; BV 24 vs 7), resulting in more patients receiving treatment. CONCLUSIONS: A 'sample first' clinical pathway to enable multiple POCT use was acceptable to patients and feasible in a busy sexual health clinic, but rapid CT/NG processing time was too long to enable POCT use. There is need for further development to improve test processing times to enable POC use of rapid NAATs. |
| تدمد: | 1472-3263 1368-4973 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::35e11eab11042d27fb1d1e1e244ae380Test https://doi.org/10.1136/sextrans-2016-052988Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....35e11eab11042d27fb1d1e1e244ae380 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14723263 13684973 |
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