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C 反应蛋白即时检测在下呼吸道感染中的应用:全科医生经验的定性评价。

C-reactive protein point-of-care testing for lower respiratory tract infections: a qualitative evaluation of experiences by GPs.

机构信息

Department of General Practice, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands.

出版信息

Fam Pract. 2010 Apr;27(2):212-8. doi: 10.1093/fampra/cmp088. Epub 2009 Dec 18.

Abstract

OBJECTIVES

To explore GPs' attitudes to and experiences of introducing C-reactive protein (CRP) point-of-care testing (POCT) for lower respiratory tract infections (LRTI) in primary care.

METHODS

Semi-structured interview study with 20 GPs who participated in the IMPAC(3)T randomized trial evaluating the effect of GP use of CRP POCT on management of LRTI. Main outcomes were GPs' experiences and views about CRP POCT in general practice, including its role in guiding antibiotic prescribing decisions and applicability and implementation in daily practice.

RESULTS

GPs expressed mainly positive attitudes. Test results were rapidly available to support diagnostic and therapeutic processes for LRTI and other common infections, enhancing patient and GP confidence in prescribing decisions and empowering GPs to prescribe antibiotics less often. GPs were concerned about responding to ambiguous test results. They regarded financial reimbursement for using the test as essential for successful uptake.

CONCLUSIONS

GPs were generally positive about CRP POCT, and they felt that it empowered them to safely prescribe fewer antibiotics for LRTI without alienating their patients. Successful wider implementation should address reimbursement and updating management guidelines to include the place of CRP POCT.

摘要

目的

探索全科医生(GP)对在初级保健中引入 C 反应蛋白(CRP)即时检测(POCT)用于下呼吸道感染(LRTI)的态度和经验。

方法

对 20 名参与 IMPAC(3)T 随机试验的 GP 进行半结构式访谈研究,该试验评估了 GP 使用 CRP POCT 对 LRTI 管理的影响。主要结局是 GP 对一般实践中 CRP POCT 的经验和观点,包括其在指导抗生素处方决策以及在日常实践中的适用性和实施方面的作用。

结果

GP 表达了主要的积极态度。测试结果可快速获得,以支持 LRTI 和其他常见感染的诊断和治疗过程,增强了患者和 GP 在处方决策方面的信心,并使 GP 能够减少抗生素的使用频率。GP 对模糊的测试结果感到担忧。他们认为使用该测试的财务报销对于成功采用至关重要。

结论

GP 对 CRP POCT 总体持积极态度,他们认为这使他们能够安全地减少对 LRTI 的抗生素使用,而不会疏远患者。要实现更广泛的成功实施,应解决报销问题,并更新管理指南以包括 CRP POCT 的位置。

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