title: A multi-country qualitative study of clinicians' and patients' views on point of care tests for lower respiratory tract infection.
abstract: BACKGROUND
  Point of care tests (POCTs) are being promoted to better target antibiotic prescribing with the aim of improving outcomes and containing antibiotic resistance.
  
  
  OBJECTIVE
  We aimed to explore clinician and patient views about POCTs to assist with the diagnosis and management of lower respiratory tract infection (LRTI) in primary care.
  
  
  METHODS
  Multi-country European qualitative interview study with 80 primary care clinicians and 121 adult patients in nine primary care networks who had recently consulted with symptoms of acute cough/LRTI. Transcripts were subjected to a five-stage analytic framework approach (familiarization, developing a thematic framework from the interview questions and the themes emerging from the data, indexing, charting, and mapping to search for interpretations in the data), with local network facilitators commenting on preliminary reports.
  
  
  RESULTS
  Clinicians who did not routinely use POCTs for acute cough/LRTI felt that the tests' advantages included managing patient expectations for antibiotics. Perceived disadvantages included questionable test performance, problems interpreting results, a detraction from clinical reasoning, costs, time and patients not wanting, or demanding, the tests. Clinicians who routinely used POCTs echoed these disadvantages. Almost all patients would be happy to be managed with the addition of a POCT. Patients with experience of POCTs accepted it as part of routine care.
  
  
  CONCLUSIONS
  Acceptability of POCTs to clinicians is likely to be improved if tests perform well on accuracy, time to result, simplicity and cost. Including POCTs in the routine management of acute cough/LRTI is likely to be acceptable to most patients.
authors.affiliation: Department of Primary Care and Public Health, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, UK. wood@cardiff.ac.uk
authors.forename: Fiona
authors.initials: F
authors.lastname: Wood
authors.forename: Lucy
authors.initials: L
authors.lastname: Brookes-Howell
authors.forename: Kerenza
authors.initials: K
authors.lastname: Hood
authors.forename: Lucy
authors.initials: L
authors.lastname: Cooper
authors.forename: Theo
authors.initials: T
authors.lastname: Verheij
authors.forename: Herman
authors.initials: H
authors.lastname: Goossens
authors.forename: Paul
authors.initials: P
authors.lastname: Little
authors.forename: Maciek
authors.initials: M
authors.lastname: Godycki-Cwirko
authors.forename: Niels
authors.initials: N
authors.lastname: Adriaenssens
authors.forename: Kristin
authors.initials: K
authors.lastname: Jakobsen
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Butler
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D002097:C-Reactive Protein / Q000032:analysis*; D003371:Cough / Q000209:etiology; D003657:Decision Making; D005060:Europe; D006801:Humans; D007407:Interviews as Topic; D010342:Patient Acceptance of Health Care; D019095:Point-of-Care Systems; D010818:Practice Patterns, Physicians'; D036301:Qualitative Research; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D002097:C-Reactive Protein