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Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives

Background: The high burden of disease in South Africa presents challenges to public health services. Point-of-care (POC) technologies have the potential to address these gaps and improve healthcare systems. This study ascertained the acceptability and impact of POC CD4 testing on patients’ health a...

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Autores principales: Reddy, Shabashini, Gibbs, Andrew, Spooner, Elizabeth, Ngomane, Noluthando, Reddy, Tarylee, |Luthuli, Nozipho, Ramjee, Gita, Coutsoudis, Anna, Kiepiela, Photini
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7168920/
https://www.ncbi.nlm.nih.gov/pubmed/32024166
http://dx.doi.org/10.3390/diagnostics10020081
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author Reddy, Shabashini
Gibbs, Andrew
Spooner, Elizabeth
Ngomane, Noluthando
Reddy, Tarylee
|Luthuli, Nozipho
Ramjee, Gita
Coutsoudis, Anna
Kiepiela, Photini
author_facet Reddy, Shabashini
Gibbs, Andrew
Spooner, Elizabeth
Ngomane, Noluthando
Reddy, Tarylee
|Luthuli, Nozipho
Ramjee, Gita
Coutsoudis, Anna
Kiepiela, Photini
author_sort Reddy, Shabashini
collection PubMed
description Background: The high burden of disease in South Africa presents challenges to public health services. Point-of-care (POC) technologies have the potential to address these gaps and improve healthcare systems. This study ascertained the acceptability and impact of POC CD4 testing on patients’ health and clinical management. Methods: We conducted a qualitative survey study with patients (n = 642) and healthcare providers (n = 13) at the Lancers Road (experienced POC) and Chesterville (non-experienced POC) primary healthcare (PHC) clinics from September 2015 to June 2016. Results: Patients (99%) at Lancers and Chesterville PHCs were positive about POC CD4 testing, identifying benefits: No loss/delay of test results (6.4%), cost/time saving (19.5%), and no anxiety (5.1%), and 58.2% were ready to initiate treatment. Significantly more patients at Chesterville than Lancers Road PHC felt POC would provide rapid clinical decision making (64.7% vs. 48.1%; p < 0.0001) and better clinic accessibility (40.4% vs. 24.7%; p < 0.0001) respectively. Healthcare providers thought same-day CD4 results would impact: Clinical management (46.2%), patient readiness (46.2%), and adherence (23.0%), and would reduce follow-up visits (7.7%), while 38.5% were concerned that further tests and training (15.4%) were required before antiretroviral therapy (ART) initiation. Conclusion: The high acceptability of POC CD4 testing and the immediate health, structural, and clinical management benefits necessitates POC implementation studies.
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spelling pubmed-71689202020-04-20 Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives Reddy, Shabashini Gibbs, Andrew Spooner, Elizabeth Ngomane, Noluthando Reddy, Tarylee |Luthuli, Nozipho Ramjee, Gita Coutsoudis, Anna Kiepiela, Photini Diagnostics (Basel) Article Background: The high burden of disease in South Africa presents challenges to public health services. Point-of-care (POC) technologies have the potential to address these gaps and improve healthcare systems. This study ascertained the acceptability and impact of POC CD4 testing on patients’ health and clinical management. Methods: We conducted a qualitative survey study with patients (n = 642) and healthcare providers (n = 13) at the Lancers Road (experienced POC) and Chesterville (non-experienced POC) primary healthcare (PHC) clinics from September 2015 to June 2016. Results: Patients (99%) at Lancers and Chesterville PHCs were positive about POC CD4 testing, identifying benefits: No loss/delay of test results (6.4%), cost/time saving (19.5%), and no anxiety (5.1%), and 58.2% were ready to initiate treatment. Significantly more patients at Chesterville than Lancers Road PHC felt POC would provide rapid clinical decision making (64.7% vs. 48.1%; p < 0.0001) and better clinic accessibility (40.4% vs. 24.7%; p < 0.0001) respectively. Healthcare providers thought same-day CD4 results would impact: Clinical management (46.2%), patient readiness (46.2%), and adherence (23.0%), and would reduce follow-up visits (7.7%), while 38.5% were concerned that further tests and training (15.4%) were required before antiretroviral therapy (ART) initiation. Conclusion: The high acceptability of POC CD4 testing and the immediate health, structural, and clinical management benefits necessitates POC implementation studies. MDPI 2020-02-01 /pmc/articles/PMC7168920/ /pubmed/32024166 http://dx.doi.org/10.3390/diagnostics10020081 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Reddy, Shabashini
Gibbs, Andrew
Spooner, Elizabeth
Ngomane, Noluthando
Reddy, Tarylee
|Luthuli, Nozipho
Ramjee, Gita
Coutsoudis, Anna
Kiepiela, Photini
Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives
title Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives
title_full Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives
title_fullStr Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives
title_full_unstemmed Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives
title_short Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives
title_sort assessment of the impact of rapid point-of-care cd4 testing in primary healthcare clinic settings: a survey study of client and provider perspectives
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7168920/
https://www.ncbi.nlm.nih.gov/pubmed/32024166
http://dx.doi.org/10.3390/diagnostics10020081
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