Respiratory point of care testing (R-POCT) to facilitate management in the community for COPD exacerbations: A novel home-based service
This pilot project was designed to explore whether incorporation of R-POCT, respiratory point of care bedside testing, within our hospital at home service in the community would improve quality of patient care by ensuring delivery of a more personalised management plan whereby treatment is guided by objective clinical testing.
Currently COPD exacerbations are often treated empirically with antibiotics and steroids, despite a large proportion being viral induced or non-infective and sometimes with a component of anxiety especially in more end stage disease.
R-POCT tests included CRP, procalcitonin and a panel of 18 respiratory viruses and 4 atypical bacteria using blood and nasopharyngeal or sputum samples taken by nurses in patients’ homes without the requirement to attend a clinic or hospital setting. Sample analysis is undertaken by these nurses in a community hub before results and a guided management plan are fed back within a couple of hours to the patient.
- Comparison of this patient cohort before and after the implementation of R-POCT, showed statistically significant improvement following implementation of this service in the areas below:
- 1.Reduced antibiotic prescribing with improved antimicrobial stewardship
- 2.Avoidance of hospital admission and ED attendance
- 3.Improved patient experience and quality of life (QOL)