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MSc_Heleen_Hofland NPM - Point of care testing and selftest...

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Point of care testing and selftest related consultations in general practices in the Netherlands: an exploratory study on general practitioners’ experiences H.J. Hofland (s0089796) 2010-07-02 Health Technology and Services Research (HTSR) School of Management and Governance, University of Twente, Enschede, the Netherlands Executed at the National Institute for Public Health and the Environment (RIVM) Centre for Biological Medicines and Medical Technology (BMT), Section Medical Technology (MET) Supervisors University of Twente Prof. Dr. M.J. IJzerman Dr. C.J.M. Doggen RIVM Dr. E.S.M. Hilbers Ir. R.E. Geertsma
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Abstract Background: In recent years, a wide range of in vitro diagnostic (IVD) point of care tests (POC) and selftests have become available for use by health professionals and individual consumers or patients. Both types of tests may have potential benefits and consequences for general practice care. Therefore, the present study investigated GPs experiences with POC testing and selftest related consultations in general practices in the Netherlands. Methods: Two-phased study design, i.e. questionnaire followed by semi-structured interviews. Three-hundred randomly selected GPs from the NIVEL register of GPs were sent a questionnaire that collected data regarding the use of POC tests and occurrence of selftest related consultations in general practice. Subsequently, 11 self-enrolled GPs were contacted for an interview to discuss their experiences in greater depth. Descriptive statistics were used to assess the questionnaire answers. Interviews were recorded and analysed using thematic analysis. Results: Usable questionnaires were returned by 123/294 GPs (42%). Experiences with POC testing related mainly to three types of tests (nitrite, glucose and haemoglobin) for which the users were classified as ‘general users’, representing 80% of the GPs. The other 20% of the GPs were classified as ‘innovative users’ by their use of additional tests (D-dimer, candida, cholesterol, faecal occult blood, C- reactive protein, troponin and glandular fever test). A large proportion of 70% of the GPs reported willingness to use additional tests in the future. Overall, interviews illustrated satisfaction with current routines wherein the GPs’ assistant operates the POC tests in practice. Additional tests would be considered for implementation if value is demonstrated and costs are reimbursed. Experiences with selftest related consultations were limited to only one third of the GPs observing selftests. Most often observed selftests included tests for diabetes, kidney disease, female fertility and cholesterol. Interviewed GPs had almost no experience with selftest related consultations and accordingly they did not feel that the use of selftests has consequences for general practice care.
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