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’...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2020-02-01
|
| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/10/2/81 |
| _version_ | 1818038991307407360 |
|---|---|
| author | Shabashini Reddy Andrew Gibbs Elizabeth Spooner Noluthando Ngomane Tarylee Reddy Nozipho |Luthuli Gita Ramjee Anna Coutsoudis Photini Kiepiela |
| author_facet | Shabashini Reddy Andrew Gibbs Elizabeth Spooner Noluthando Ngomane Tarylee Reddy Nozipho |Luthuli Gita Ramjee Anna Coutsoudis Photini Kiepiela |
| author_sort | Shabashini Reddy |
| collection | DOAJ |
| description | 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’ 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> < 0.0001) and better clinic accessibility (40.4% vs. 24.7%; <i>p</i> < 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. |
| first_indexed | 2024-12-10T07:51:32Z |
| format | Article |
| id | doaj.art-18a6863f74cf4695a82328baec082bb3 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-12-10T07:51:32Z |
| publishDate | 2020-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-18a6863f74cf4695a82328baec082bb32022-12-22T01:57:01ZengMDPI AGDiagnostics2075-44182020-02-011028110.3390/diagnostics10020081diagnostics10020081Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider PerspectivesShabashini Reddy0Andrew Gibbs1Elizabeth Spooner2Noluthando Ngomane3Tarylee Reddy4Nozipho |Luthuli5Gita Ramjee6Anna Coutsoudis7Photini Kiepiela8South African Medical Research Council, Durban 4000, South AfricaSouth African Medical Research Council, Gender and Health Research Unit, Durban Centre for Rural Health, University of KwaZulu Natal, Durban 4000, South AfricaSouth African Medical Research Council, HIV Prevention Research Unit, Durban 3600, South AfricaOccupational Health, Hillcrest, Durban 3610, South AfricaSouth African Medical Research Council, Biostatistics Unit, Durban 4000, South AfricaeThekwini Health Unit, Durban 4000, South AfricaSouth African Medical Research Council, HIV Prevention Research Unit, Durban 3600, South AfricaSchool of Clinical Medicine, University of KwaZulu Natal, Durban 4000, South AfricaSouth African Medical Research Council, Durban 4000, South AfricaBackground: 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’ 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> < 0.0001) and better clinic accessibility (40.4% vs. 24.7%; <i>p</i> < 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.https://www.mdpi.com/2075-4418/10/2/81point-of-care cd4+ t testingqualitative surveyacceptabilitypatientshealthcare providersprimary healthcare clinics |
| spellingShingle | Shabashini Reddy Andrew Gibbs Elizabeth Spooner Noluthando Ngomane Tarylee Reddy Nozipho |Luthuli Gita Ramjee Anna Coutsoudis Photini Kiepiela Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives Diagnostics point-of-care cd4+ t testing qualitative survey acceptability patients healthcare providers primary healthcare clinics |
| title | Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives |
| title_full | Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives |
| title_fullStr | Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives |
| title_full_unstemmed | Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives |
| title_short | Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives |
| title_sort | assessment of the impact of rapid point of care cd4 testing in primary healthcare clinic settings a survey study of client and provider perspectives |
| topic | point-of-care cd4+ t testing qualitative survey acceptability patients healthcare providers primary healthcare clinics |
| url | https://www.mdpi.com/2075-4418/10/2/81 |
| work_keys_str_mv | AT shabashinireddy assessmentoftheimpactofrapidpointofcarecd4testinginprimaryhealthcareclinicsettingsasurveystudyofclientandproviderperspectives AT andrewgibbs assessmentoftheimpactofrapidpointofcarecd4testinginprimaryhealthcareclinicsettingsasurveystudyofclientandproviderperspectives AT elizabethspooner assessmentoftheimpactofrapidpointofcarecd4testinginprimaryhealthcareclinicsettingsasurveystudyofclientandproviderperspectives AT noluthandongomane assessmentoftheimpactofrapidpointofcarecd4testinginprimaryhealthcareclinicsettingsasurveystudyofclientandproviderperspectives AT taryleereddy assessmentoftheimpactofrapidpointofcarecd4testinginprimaryhealthcareclinicsettingsasurveystudyofclientandproviderperspectives AT nozipholuthuli assessmentoftheimpactofrapidpointofcarecd4testinginprimaryhealthcareclinicsettingsasurveystudyofclientandproviderperspectives AT gitaramjee assessmentoftheimpactofrapidpointofcarecd4testinginprimaryhealthcareclinicsettingsasurveystudyofclientandproviderperspectives AT annacoutsoudis assessmentoftheimpactofrapidpointofcarecd4testinginprimaryhealthcareclinicsettingsasurveystudyofclientandproviderperspectives AT photinikiepiela assessmentoftheimpactofrapidpointofcarecd4testinginprimaryhealthcareclinicsettingsasurveystudyofclientandproviderperspectives |