title: Qualitative study of primary care clinicians' views on point-of-care testing for C-reactive protein for acute respiratory tract infections in family medicine.
abstract: To explore clinicians views of the barriers and facilitators to use of C-reactive protein (CRP) point-of-care tests (POCT) in US family medicine clinics for the management of acute respiratory tract infections (ARTIs) in adults.
  
  
  
  Five family medicine clinics across two US states.
  
  
  
  30 clinicians including 18 physicians, 9 physician residents, 2 physician assistants and 1 nurse practitioner, took part in the study.
  
  
  
  A qualitative study using a grounded theory approach to thematically analyse focus group interviews.
  
  
  
  These clinicians had limited access to diagnostic tests for patients with ARTI, and very little knowledge of CRP POCT. Three major themes were identified and included the potential clinical role of CRP POCT, concerns related to implementing CRP POCT and evidence needed prior to wider adoption in family medicine. Clinicians believed CRP POCT could support decision-making for some presentations of ARTIs and patient populations when used in conjunction with clinical criteria. Clinicians had concerns about possible overuse and inaccuracy of CRP POCT which they believed might increase antibiotic prescribing rates. Other concerns identified included integration of the test with clinic workflows and cost-effectiveness.
  
  
  
  Clinicians stand at the forefront of antibiotic stewardship efforts, but have few diagnostic tests to help them confidently manage ARTIs. CRP POCT may facilitate some aspects of clinical practice. Incorporating CRP POCT with clinical guidelines may strengthen utility of this test, when there is diagnostic uncertainty.
authors.affiliation: Department of Family Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: Victoria
authors.initials: V
authors.lastname: Hardy
authors.affiliation: Department of Family Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Thompson
authors.affiliation: Department of Family Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: Gina A
authors.initials: GA
authors.lastname: Keppel
authors.affiliation: Seattle Indian Health Board, Seattle, Washington, USA.
authors.forename: William
authors.initials: W
authors.lastname: Alto
authors.affiliation: Swedish Family Medicine First Hill, Seattle, Washington, USA.
authors.forename: M Ashworth
authors.initials: MA
authors.lastname: Dirac
authors.affiliation: Valley Family Medicine, Renton, Washington, USA.
authors.forename: Jon
authors.initials: J
authors.lastname: Neher
authors.affiliation: Department of Family Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Sanford
authors.affiliation: Family Medicine Residency, University of Wyoming, Casper, Wyoming, USA.
authors.forename: Jaime
authors.initials: J
authors.lastname: Hornecker
authors.affiliation: Department of Family Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: Allison
authors.initials: A
authors.lastname: Cole
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D002097:C-Reactive Protein / Q000378:metabolism*; D000066491:Clinical Decision-Making; D005194:Family Practice; D005260:Female; D017144:Focus Groups; D066296:Grounded Theory; D006801:Humans; D008297:Male; D008875:Middle Aged; D010823:Physician Assistants; D058007:Physicians, Primary Care; D000067716:Point-of-Care Testing; D057184:Practice Patterns, Nurses'; D036301:Qualitative Research; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D002097:C-Reactive Protein
keywords: INFECTIOUS DISEASES