Primary care clinicians' attitudes towards point-of-care blood testing: a systematic review of qualitative studies.
BACKGROUND
Point-of-care blood tests are becoming increasingly available and could replace current venipuncture and laboratory testing for many commonly used tests. However, at present very few have been implemented in most primary care settings. Understanding the attitudes of primary care clinicians towards these tests may help to identify the barriers and facilitators to their wider adoption. We aimed to systematically review qualitative studies of primary care clinicians' attitudes to point-of-care blood tests.


METHODS
We systematically searched Medline, Embase, ISI Web of Knowledge, PsycINFO and CINAHL for qualitative studies of primary care clinicians' attitudes towards point-of-care blood tests in high income countries. We conducted a thematic synthesis of included studies.


RESULTS
Our search identified seven studies, including around two hundred participants from Europe and Australia. The synthesis generated three main themes: the impact of point-of-care testing on decision-making, diagnosis and treatment; impact on clinical practice more broadly; and impact on patient-clinician relationships and perceived patient experience. Primary care clinicians believed point-of-care testing improved diagnostic certainty, targeting of treatment, self-management of chronic conditions, and clinician-patient communication and relationships. There were concerns about test accuracy, over-reliance on tests, undermining of clinical skills, cost, and limited usefulness.


CONCLUSIONS
We identified several perceived benefits and barriers regarding point-of-care tests in primary care. These imply that if point-of-care tests are to become more widely adopted, primary care clinicians require evidence of their accuracy, rigorous testing of the impact of introduction on patient pathways and clinical practice, and consideration of test funding.
Department of Primary Care Health Sciences, University of Oxford, UK. caroline.jones@phc.ox.ac.uk
Caroline H D
CH
Jones
Jeremy
J
Howick
Nia W
NW
Roberts
Christopher P
CP
Price
Carl
C
Heneghan
Annette
A
Plüddemann
Matthew
M
Thompson
D001291:Attitude of Health Personnel; D001315:Australia; D016208:Databases, Factual; D003906:Developing Countries; D004059:Diffusion of Innovation; D005060:Europe; D007722:Health Knowledge, Attitudes, Practice; D006403:Hematologic Tests / Q000523:psychology* / Q000592:standards; D006801:Humans; D019095:Point-of-Care Systems; D011320:Primary Health Care; D036301:Qualitative Research; D000078329:Workforce