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首页> 外文期刊>Clinical pharmacist >DIAGNOSTICS:Evaluating point-of-care C-reactive protein testing in a general practice
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DIAGNOSTICS:Evaluating point-of-care C-reactive protein testing in a general practice

机译：诊断：在一般实践中评估即时护理C反应蛋白测试

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Background: C-reactive protein (CRP) is a marker of infection and inflammation. It is high in bacterial infections but very low or close to zero in viral infections. The National Institute for Health and Oare Excellence (NICE), England and Wales' health technology assessment body, has issued guidance on pneumonia in adults; it recommends point-of-care (POC) CRP analysers when clinical assessment is inconclusive. If the CRP level is less than 20mg/L, no antibiotics should be offered; if 20-100mg/L delayed prescriptions should be considered; and if over 100mg/L an antibiotic should be offered. A pilot study was undertaken in a GP practice in Anglesey, North Wales, to determine whether POC CRP testing had an impact on antibiotic prescription rates. Method: The POC CRP analyser was introduced into clinical practice over a three-month period (November 2015 to January 2016). This involved the choice and accuracy checking of the analyser by the biochemistry laboratory. The evaluation included a patient focus group and user questionnaire. Results: Overall, 94 patients received POC CRP tests; 71 patients for acute respiratory tract infections (RTIs) and 23 patients for other indications. Of the 71 respiratory patients, 53 (74.6%) patients did not receive an antibiotic. Compared with the same three-month period the previous year (November 2014 to January 2015), antibiotic prescriptions decreased by 21.39%. This was statistically significant (P=0.04) when compared with other practices in the health board, where antibiotic prescription rates fell by 10.6%. Patient and user feedback was also positive. Discussion: Although the POC CRP analyser was introduced for managing acute RTIs only, 23 patients received a test for other indications. Healthcare professionals within primary care may find rapid access to a CRP result useful for managing other clinical conditions. Conclusion: There is limited experience of POC ORP analysers in GP practices and this report discusses the practical experience and iearning gained from a pilot study required to facilitate further roll-out.
机译：背景：C反应蛋白（CRP）是感染和炎症的标志。细菌感染率很高，但病毒感染率很低或接近于零。英格兰和威尔士的健康技术评估机构国家卫生与矿产资源研究院（NICE）已发布了成人肺炎的指南;当临床评估尚无定论时，建议使用即时医疗（POC）CRP分析仪。如果CRP水平低于20mg / L，则不应使用抗生素。是否应考虑20-100mg / L延迟处方;如果超过100mg / L，则应提供抗生素。在北威尔士安格尔西的GP诊所进行了一项初步研究，以确定POC CRP检测是否对抗生素处方率有影响。方法：POC CRP分析仪在三个月的时间内（2015年11月至2016年1月）被引入临床实践。这涉及生化实验室对分析仪的选择和准确性检查。评估包括患者焦点小组和用户问卷。结果：总共94例患者接受了POC CRP检测; 71例急性呼吸道感染（RTIs）患者和23例其他适应症患者。在71名呼吸道疾病患者中，有53名（74.6％）患者未接受抗生素治疗。与去年同期（2014年11月至2015年1月）的三个月相比，抗生素处方减少了21.39％。与卫生局的其他做法相比，这具有统计学意义（P = 0.04），后者的抗生素处方率下降了10.6％。病人和用户的反馈也很积极。讨论：尽管POC CRP分析仪仅用于管理急性RTI，但仍有23名患者接受了其他适应症的检测。初级保健中的医疗保健专业人员可能会发现快速获得CRP结果对于管理其他临床状况很有用。结论：POC ORP分析仪在GP实践中的经验有限，本报告讨论了从为进一步推广所需的试点研究中获得的实践经验和经验教训。

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