Abstract
Background: Rapid, cost-effective diagnosis of acute respiratory infections is now possible using multi-viral rapid-antigen point-of-care-tests (MVRA-POCTs) with high sensitivity/specificity. These offer a realistic alternative to polymerase chain reaction tests in primary care. However, evidence of acceptability and clinical utility in this setting is limited.
Aim: To pilot feasibility of integrating MVRA-POCTs into routine primary care and investigate patient/clinician attitudes and behaviours.
Design & setting: A prospective mixed-methods pilot study in seven New Zealand primary care clinics during winter 2023.
Method: Patients with acute respiratory symptoms received a MVRA-POCT (instead of COVID-19-only). Outcomes and acceptability were assessed via audits of electronic medical records, clinician/patient surveys, and interviews/focus groups with patients/clinic staff.
Results: Swab results were recorded from a demographically diverse cohort of 1754 patients; 14% tested positive for any virus (246/1754). All clinicians and most patients surveyed positively evaluated the test. All clinicians incorporated the MVRA-POCT into practice and found it useful. 66% of prescribers (27/41) reported results influenced antibiotic prescribing; 12% (5/41) avoided referrals to secondary care. All patient respondents who tested positive (n=39) and most testing negative (172/180, 96%) would like the MVRA-POCT in future. Patients testing positive self-reported as more likely to follow non-pharmaceutical interventions to reduce transmission compared to those testing negative.
Conclusion: MVRA-POCTs were well-accepted and readily incorporated into practice. Routine integration into primary care could potentially improve management of common respiratory illnesses and promote patient behaviour change to reduce transmission.