Implementing PCR testing in general practice—a qualitative study using normalization process theory
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Implementing PCR testing in general practice—a qualitative study using normalization process theory. / Shahrzad, Sinead; Balasubramaniam, Kirubakaran; Kousgaard, Marius Brostrøm; Thilsing, Trine; Søndergaard, Jens; Overbeck, Gritt.
In: BMC Health Services Research, Vol. 23, No. 1, 1325, 2023.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Implementing PCR testing in general practice—a qualitative study using normalization process theory
AU - Shahrzad, Sinead
AU - Balasubramaniam, Kirubakaran
AU - Kousgaard, Marius Brostrøm
AU - Thilsing, Trine
AU - Søndergaard, Jens
AU - Overbeck, Gritt
N1 - Publisher Copyright: © 2023, The Author(s).
PY - 2023
Y1 - 2023
N2 - Background: The COVID-19 pandemic brought attention to a need for rapid testing of large populations. Experiences from community-based testing settings show that there can be workload difficulties, logistical challenges and socioeconomic downsides to large scale Polymerase Chain Reaction (PCR) testing. Alternative testing arenas have therefore been considered. Rapid point-of-care (POC) PCR test methods have since been developed and could have potential to surveille viral respiratory infections. It is, however, unknown if PCR testing can be successfully implemented routinely in general practice. The aim of this study was to assess factors that enable and inhibit the implementation of point-of-care PCR testing for acute respiratory tract infection in general practice. Methods: Fourteen general practices in the east Zealand area in Denmark were included in the study and given access to POC PCR testing equipment during a flu season. The participating clinics were initially trained in the use of a POC PCR testing device and then spent 6 weeks testing it. We conducted qualitative interviews with general practitioners (GPs) and their staff, before and after the testing period, specifically focusing on their clinical decision-making and internal collaboration in relation to POC PCR testing. We used normalization process theory to design the interview guides and to analyze the data. Results: Professionals reported no clinical need for a POC PCR testing device in a non-pandemic clinical setting. Results were delivered faster, but this was only timesaving for the patient and not the GP, who had to perform more tasks. Conclusion: In its current form, the added diagnostic value of using POC PCR testing in general practice was not sufficient for the professionals to justify the increased work connected to the usage of the diagnostic procedure in daily practice. Trial registration: n/a.
AB - Background: The COVID-19 pandemic brought attention to a need for rapid testing of large populations. Experiences from community-based testing settings show that there can be workload difficulties, logistical challenges and socioeconomic downsides to large scale Polymerase Chain Reaction (PCR) testing. Alternative testing arenas have therefore been considered. Rapid point-of-care (POC) PCR test methods have since been developed and could have potential to surveille viral respiratory infections. It is, however, unknown if PCR testing can be successfully implemented routinely in general practice. The aim of this study was to assess factors that enable and inhibit the implementation of point-of-care PCR testing for acute respiratory tract infection in general practice. Methods: Fourteen general practices in the east Zealand area in Denmark were included in the study and given access to POC PCR testing equipment during a flu season. The participating clinics were initially trained in the use of a POC PCR testing device and then spent 6 weeks testing it. We conducted qualitative interviews with general practitioners (GPs) and their staff, before and after the testing period, specifically focusing on their clinical decision-making and internal collaboration in relation to POC PCR testing. We used normalization process theory to design the interview guides and to analyze the data. Results: Professionals reported no clinical need for a POC PCR testing device in a non-pandemic clinical setting. Results were delivered faster, but this was only timesaving for the patient and not the GP, who had to perform more tasks. Conclusion: In its current form, the added diagnostic value of using POC PCR testing in general practice was not sufficient for the professionals to justify the increased work connected to the usage of the diagnostic procedure in daily practice. Trial registration: n/a.
KW - Evaluation
KW - Implementation
KW - Normalization process theory
KW - POC PCR testing
U2 - 10.1186/s12913-023-10355-4
DO - 10.1186/s12913-023-10355-4
M3 - Journal article
C2 - 38037044
AN - SCOPUS:85178183469
VL - 23
JO - BMC Health Services Research
JF - BMC Health Services Research
SN - 1472-6963
IS - 1
M1 - 1325
ER -
ID: 376251313