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&#8217...

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Bibliographic Details
Main Authors: Shabashini Reddy, Andrew Gibbs, Elizabeth Spooner, Noluthando Ngomane, Tarylee Reddy, Nozipho |Luthuli, Gita Ramjee, Anna Coutsoudis, Photini Kiepiela
Format: Article
Language:English
Published: MDPI AG 2020-02-01
Series:Diagnostics
Subjects:
Online Access:https://www.mdpi.com/2075-4418/10/2/81
Description
Summary: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&#8217; health and clinical management. Methods: We conducted a qualitative survey study with patients (<i>n</i> = 642) and healthcare providers (<i>n</i> = 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%; <i>p</i> &lt; 0.0001) and better clinic accessibility (40.4% vs. 24.7%; <i>p</i> &lt; 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.
ISSN:2075-4418