Patient perceptions of primary care rapid respiratory microbiological point-of-care testing: a qualitative study.

Abstract

Rapid microbiological point-of-care tests (RM-POCTs) have the potential to reduce antimicrobial overuse for respiratory tract infections (RTIs). However, patient perspectives regarding RM-POCTs remain unclear. Therefore, this study aimed to explore patients' and parents' experiences using RM-POCTs for RTIs and their views on how RM-POCTs influence treatment decisions, symptom management and future consulting. A qualitative study using in-depth, semistructured interviews. Data were analysed thematically, informed by a realist approach. Interviewees were recruited from a multicentre, individually randomised controlled efficacy trial evaluating the use of a multiplex RM-POCT for suspected RTIs in primary care. Purposive sample of primary care patients (n=21 adults, 9 parents) participating in the trial. In general, participants viewed RM-POCTs favourably. Patients believed RM-POCTs reduced diagnostic uncertainty but emphasised that RM-POCTs should be used alongside clinical judgement. For some, additional information from RM-POCTs created positive outcome expectancies and reduced the perception that antibiotics were necessary. Others felt invalidated by RM-POCTs' results or believed further support was necessary to understand when antibiotics were needed and how they could manage symptoms. While RM-POCTs may reduce reconsulting for the same illness, participants indicated future consulting behaviours would persist for self-limiting symptoms or health anxiety. Increased consulting may occur if patients perceive RM-POCTs to reduce pressure on primary care. RM-POCT offers the potential to improve self-efficacy beliefs and reduce reconsulting for the same illness. Effective clinician communication and patient education may be beneficial alongside RM-POCTs to minimise unintended outcomes and enhance patients' ability to determine when primary care attendance is necessary in the future. ISRCTN16039192.