title: A qualitative study of GP, NP and patient views about the use of rapid streptococcal antigen detection tests (RADTs) in primary care: 'swamped with sore throats?'.
abstract: OBJECTIVE
  To explore patient and healthcare professionals' (HCP) views of clinical scores and rapid streptococcal antigen detection tests (RADTs) for acute sore throat.
  
  
  METHODS
  Qualitative semistructured interview study.
  
  
  METHODS
  UK primary care.
  
  
  METHODS
  General practitioners (GPs), nurse practitioners (NPs) and patients from general practices across Hampshire, Oxfordshire and the West Midlands who were participating in the Primary Care Streptococcal Management (PRISM) study.
  
  
  METHODS
  Semistructured, face-to-face and phone interviews were conducted with GPs, NPs and patients from general practices across Hampshire, Oxfordshire and the West Midlands.
  
  
  RESULTS
  51 participants took part in the study. Of these, 42 were HCPs (29 GPs and 13 NPs) and 9 were patients. HCPs could see a positive role for RADTs in terms of reassurance, as an educational tool for patients, and for aiding inexperienced practitioners, but also had major concerns about RADT use in clinical practice. Particular concerns included the validity of the tests (the role of other bacteria, and carrier states), the tension and possible disconnect with clinical assessment and intuition, the issues of time and resource use and the potential for medicalisation of self-limiting illness. In contrast, however, experience of using RADTs over time seemed to make some participants more positive about using the tests. Moreover, patients were much more positive about the place of RADTs in providing reassurance and in limiting their antibiotic use.
  
  
  CONCLUSIONS
  It is unlikely that RADTs will have a (comfortable) place in clinical practice in the near future until health professionals' concerns are met, and they have direct experience of using them. The routine use of clinical scoring systems for acute upper respiratory illness also face important barriers related to clinicians' perceptions of their utility in the face of clinician experience and intuition.
authors.affiliation: Department of Primary Care and Population Sciences, University of Southampton, Southampton, UK.
authors.forename: Gerry M
authors.initials: GM
authors.lastname: Leydon
authors.forename: Lisa
authors.initials: L
authors.lastname: McDermott
authors.forename: Mike
authors.initials: M
authors.lastname: Moore
authors.forename: Ian
authors.initials: I
authors.lastname: Williamson
authors.forename: F D Richard
authors.initials: FD
authors.lastname: Hobbs
authors.forename: Tessa
authors.initials: T
authors.lastname: Lambton
authors.forename: Rebecca
authors.initials: R
authors.lastname: Cooper
authors.forename: Hugo
authors.initials: H
authors.lastname: Henderson
authors.forename: Paul
authors.initials: P
authors.lastname: Little
references.citation: Clin Infect Dis. 2002 Jul 15;35(2):113-25
references.pmid: 12087516
references.citation: Am Fam Physician. 2004 Mar 15;69(6):1465-70
references.pmid: 15053411
references.citation: JAMA. 2004 Apr 7;291(13):1587-95
references.pmid: 15069046
references.citation: BMJ. 2009 Mar 19;338:b663
references.pmid: 19299474
references.citation: Br J Gen Pract. 2009 Jul;59(564):e219-25
references.pmid: 19566988
references.citation: Health Technol Assess. 2009 Mar;13(19):iii-iv, ix-xi, 1-73
references.pmid: 19364448
references.citation: BMC Fam Pract. 2010 Nov 18;11:90
references.pmid: 21087469
references.citation: BMJ. 2004 Feb 21;328(7437):444
references.pmid: 14966079
references.citation: Br J Gen Pract. 2011 Feb;61(583):117-23
references.pmid: 21276338
references.citation: Ann Intern Med. 2001 Mar 20;134(6):506-8
references.pmid: 11255529
references.citation: Ann Intern Med. 2001 Mar 20;134(6):509-17
references.pmid: 11255530
references.citation: Fam Pract. 2011 Dec;28(6):661-9
references.pmid: 21653924