Point-of-care NT-proBNP monitoring for heart failure: observational feasibility study in primary care
Background: Around one million individuals in the UK have heart failure (HF), a chronic disease that causes significant morbidity and mortality. N-terminal pro-B-type natriuretic peptide (NT-proBNP) monitoring could help improve the care of patients with HF in the community. Aim: The aim of this stu...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Royal College of General Practitioners
2022-09-01
|
| Series: | BJGP Open |
| Subjects: | |
| Online Access: | https://bjgpopen.org/content/6/3/BJGPO.2022.0005 |
| _version_ | 1798000467959087104 |
|---|---|
| author | Jason Chami Susannah Fleming Clare J Taylor Clare R Bankhead Tim James Brian Shine Julie McLellan FD Richard Hobbs Rafael Perera |
| author_facet | Jason Chami Susannah Fleming Clare J Taylor Clare R Bankhead Tim James Brian Shine Julie McLellan FD Richard Hobbs Rafael Perera |
| author_sort | Jason Chami |
| collection | DOAJ |
| description | Background: Around one million individuals in the UK have heart failure (HF), a chronic disease that causes significant morbidity and mortality. N-terminal pro-B-type natriuretic peptide (NT-proBNP) monitoring could help improve the care of patients with HF in the community. Aim: The aim of this study is to provide evidence to support the routine use of point-of-care (POC) NT-proBNP monitoring in primary care. Design & setting: In this observational cohort study, the Roche Cobas h 232 POC device was used to measure NT-proBNP in 27 patients with HF at 0, 6, and 12 months, with a subset reanalysed in the laboratory for comparison. Method: Data were analysed for within-person and between-person variability and concordance with laboratory readings using Passing–Bablok regression. GPs reported whether POC results impacted clinical decisionmaking, and patients indicated their willingness to participate in long-term cohort studies using the Likert acceptability scale. Results: Within-person variability in POC NT-proBNP over 12 months was 881 pg/mL (95% confidence interval [CI] = 380 to 1382 pg/mL). Between-person variability was 1972 pg/mL (95% CI = 1,525 to 2791 pg/mL). Passing–Bablok regression showed no significant systematic difference between POC and laboratory measurements. Patients indicated a high level of acceptability, and GP decisionmaking was affected for at least one visit in a third of patients. Conclusion: Within-person variability in POC NT-proBNP is around half of between-person variability, so detecting changes could be of use in HF management. High patient acceptability and impact on clinical decisionmaking warrant further investigation in a larger long-term cohort study. |
| first_indexed | 2024-04-11T11:20:45Z |
| format | Article |
| id | doaj.art-9833b1130a2a44bbba8782ac5dea2dc0 |
| institution | Directory Open Access Journal |
| issn | 2398-3795 |
| language | English |
| last_indexed | 2024-04-11T11:20:45Z |
| publishDate | 2022-09-01 |
| publisher | Royal College of General Practitioners |
| record_format | Article |
| series | BJGP Open |
| spelling | doaj.art-9833b1130a2a44bbba8782ac5dea2dc02022-12-22T04:27:04ZengRoyal College of General PractitionersBJGP Open2398-37952022-09-016310.3399/BJGPO.2022.0005Point-of-care NT-proBNP monitoring for heart failure: observational feasibility study in primary careJason Chami0Susannah Fleming1Clare J Taylor2Clare R Bankhead3Tim James4Brian Shine5Julie McLellan6FD Richard Hobbs7Rafael Perera8Sydney Medical School, University of Sydney, Sydney, AustraliaNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UKNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UKNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UKDepartment of Clinical Biochemistry, Oxford University Hospitals NHS Foundation Trust, Oxford, UKDepartment of Clinical Biochemistry, Oxford University Hospitals NHS Foundation Trust, Oxford, UKNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UKNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UKNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UKBackground: Around one million individuals in the UK have heart failure (HF), a chronic disease that causes significant morbidity and mortality. N-terminal pro-B-type natriuretic peptide (NT-proBNP) monitoring could help improve the care of patients with HF in the community. Aim: The aim of this study is to provide evidence to support the routine use of point-of-care (POC) NT-proBNP monitoring in primary care. Design & setting: In this observational cohort study, the Roche Cobas h 232 POC device was used to measure NT-proBNP in 27 patients with HF at 0, 6, and 12 months, with a subset reanalysed in the laboratory for comparison. Method: Data were analysed for within-person and between-person variability and concordance with laboratory readings using Passing–Bablok regression. GPs reported whether POC results impacted clinical decisionmaking, and patients indicated their willingness to participate in long-term cohort studies using the Likert acceptability scale. Results: Within-person variability in POC NT-proBNP over 12 months was 881 pg/mL (95% confidence interval [CI] = 380 to 1382 pg/mL). Between-person variability was 1972 pg/mL (95% CI = 1,525 to 2791 pg/mL). Passing–Bablok regression showed no significant systematic difference between POC and laboratory measurements. Patients indicated a high level of acceptability, and GP decisionmaking was affected for at least one visit in a third of patients. Conclusion: Within-person variability in POC NT-proBNP is around half of between-person variability, so detecting changes could be of use in HF management. High patient acceptability and impact on clinical decisionmaking warrant further investigation in a larger long-term cohort study.https://bjgpopen.org/content/6/3/BJGPO.2022.0005brain natriuretic peptideheart failurepoint-of-care testingprimary health carefamily practicegeneral practice |
| spellingShingle | Jason Chami Susannah Fleming Clare J Taylor Clare R Bankhead Tim James Brian Shine Julie McLellan FD Richard Hobbs Rafael Perera Point-of-care NT-proBNP monitoring for heart failure: observational feasibility study in primary care BJGP Open brain natriuretic peptide heart failure point-of-care testing primary health care family practice general practice |
| title | Point-of-care NT-proBNP monitoring for heart failure: observational feasibility study in primary care |
| title_full | Point-of-care NT-proBNP monitoring for heart failure: observational feasibility study in primary care |
| title_fullStr | Point-of-care NT-proBNP monitoring for heart failure: observational feasibility study in primary care |
| title_full_unstemmed | Point-of-care NT-proBNP monitoring for heart failure: observational feasibility study in primary care |
| title_short | Point-of-care NT-proBNP monitoring for heart failure: observational feasibility study in primary care |
| title_sort | point of care nt probnp monitoring for heart failure observational feasibility study in primary care |
| topic | brain natriuretic peptide heart failure point-of-care testing primary health care family practice general practice |
| url | https://bjgpopen.org/content/6/3/BJGPO.2022.0005 |
| work_keys_str_mv | AT jasonchami pointofcarentprobnpmonitoringforheartfailureobservationalfeasibilitystudyinprimarycare AT susannahfleming pointofcarentprobnpmonitoringforheartfailureobservationalfeasibilitystudyinprimarycare AT clarejtaylor pointofcarentprobnpmonitoringforheartfailureobservationalfeasibilitystudyinprimarycare AT clarerbankhead pointofcarentprobnpmonitoringforheartfailureobservationalfeasibilitystudyinprimarycare AT timjames pointofcarentprobnpmonitoringforheartfailureobservationalfeasibilitystudyinprimarycare AT brianshine pointofcarentprobnpmonitoringforheartfailureobservationalfeasibilitystudyinprimarycare AT juliemclellan pointofcarentprobnpmonitoringforheartfailureobservationalfeasibilitystudyinprimarycare AT fdrichardhobbs pointofcarentprobnpmonitoringforheartfailureobservationalfeasibilitystudyinprimarycare AT rafaelperera pointofcarentprobnpmonitoringforheartfailureobservationalfeasibilitystudyinprimarycare |