Point-of-care NT-proBNP monitoring for heart failure: observational feasibility study in primary care
<strong>Background </strong>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 communi...
| Main Authors: | , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Royal College of General Practitioners
2022
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| _version_ | 1797107895659134976 |
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| author | Chami, J Fleming, S Taylor, C Bankhead, C James, T Shine, B McLellan, J Hobbs, FDR Perera, R |
| author_facet | Chami, J Fleming, S Taylor, C Bankhead, C James, T Shine, B McLellan, J Hobbs, FDR Perera, R |
| author_sort | Chami, J |
| collection | OXFORD |
| description | <strong>Background </strong>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.
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Aim</strong> 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.
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Design & setting </strong>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.
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Method </strong>Data were analysed for within- and between-person variability and concordance with laboratory readings using Passing–Bablok regression. GPs reported whether POC results impacted clinical decision-making, and patients indicated their willingness to participate in long-term cohort studies using the Likert acceptability scale.
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Results </strong>Within-person variability in POC NT-proBNP over 12 months was 881 pg/mL (95% C.I. 380–1382 pg/mL). Between-person variability was 1972 pg/mL (95% C.I. 1,525–2791 pg/mL). Passing–Bablok regression showed no significant systematic difference between POC and laboratory measurements. Patients indicated a high level of acceptability, and GP decision-making was affected for at least one visit in a third of patients.
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Conclusion </strong>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 decision-making warrant further investigation in a larger long-term cohort study. |
| first_indexed | 2024-03-07T07:20:39Z |
| format | Journal article |
| id | oxford-uuid:f8be950d-9ce8-43a4-a0a5-46732b7b2dc9 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:20:39Z |
| publishDate | 2022 |
| publisher | Royal College of General Practitioners |
| record_format | dspace |
| spelling | oxford-uuid:f8be950d-9ce8-43a4-a0a5-46732b7b2dc92022-10-03T13:15:06ZPoint-of-care NT-proBNP monitoring for heart failure: observational feasibility study in primary careJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f8be950d-9ce8-43a4-a0a5-46732b7b2dc9EnglishSymplectic ElementsRoyal College of General Practitioners2022Chami, JFleming, STaylor, CBankhead, CJames, TShine, BMcLellan, JHobbs, FDRPerera, R<strong>Background </strong>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. <br><strong> Aim</strong> 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. <br><strong> Design & setting </strong>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. <br><strong> Method </strong>Data were analysed for within- and between-person variability and concordance with laboratory readings using Passing–Bablok regression. GPs reported whether POC results impacted clinical decision-making, and patients indicated their willingness to participate in long-term cohort studies using the Likert acceptability scale. <br><strong> Results </strong>Within-person variability in POC NT-proBNP over 12 months was 881 pg/mL (95% C.I. 380–1382 pg/mL). Between-person variability was 1972 pg/mL (95% C.I. 1,525–2791 pg/mL). Passing–Bablok regression showed no significant systematic difference between POC and laboratory measurements. Patients indicated a high level of acceptability, and GP decision-making was affected for at least one visit in a third of patients. <br><strong> Conclusion </strong>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 decision-making warrant further investigation in a larger long-term cohort study. |
| spellingShingle | Chami, J Fleming, S Taylor, C Bankhead, C James, T Shine, B McLellan, J Hobbs, FDR Perera, R Point-of-care NT-proBNP monitoring for heart failure: observational feasibility study in primary care |
| 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 |
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