Evidence map›Paper›PMID 28274962›Full record

ArticleBMJ open2017

Improving prescribing practices with rapid diagnostic tests (RDTs): synthesis of 10 studies to explore reasons for variation in malaria RDT uptake and adherence.

Helen E D Burchett, Baptiste Leurent, Frank Baiden, Kimberly Baltzell, Anders Björkman, Katia Bruxvoort, Siân Clarke, Deborah DiLiberto, Kristina Elfving, Catherine Goodman and 15 more

Open access · goldAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
42citing papers in PubMed, 3 pooled it
10.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

42 citing papers in PubMed, 3 syntheses or guidelines pooled it, 77 citations in OpenAlex.

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  19. The New Precision Stewards?Journal of personalized medicine · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors at 11 institutions in 7 countries.

Helen E D BurchettDepartment of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.ORCID 0000-0002-8380-2476
Baptiste LeurentDepartment of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Frank BaidenEpidemiology Unit, Ensign College of Public Health, Kpong, Ghana.
Kimberly BaltzellDepartment of Family Health Care Nursing, and Global Health Science, University of California, Berkeley, California, USA.
Anders BjörkmanDepartment of Microbiology, Tumour and Cell Biology, Karolinska Institute, Stockholm, Sweden.
Katia BruxvoortDepartment of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
Siân ClarkeDisease Control Department, London School of Hygiene and Tropical Medicine, London, UK.
Deborah DiLibertoClinical Research Department, London School of Hygiene and Tropical Medicine, London, UK.
Kristina ElfvingDepartment of Infectious Diseases, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden.
Catherine GoodmanDepartment of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
Heidi HopkinsDisease Control Department, London School of Hygiene and Tropical Medicine, London, UK.
Sham LalDisease Control Department, London School of Hygiene and Tropical Medicine, London, UK.
Marco LiveraniDepartment of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
Pascal MagnussenFaculty of Health and Medical Sciences, Centre for Medical Parasitology, University of Copenhagen, Copenhagen, Denmark.
Andreas MårtenssonDepartment of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Wilfred MbachamLaboratory for Public Health Research Biotechnologies, The Biotechnology Center, University of Yaoundé, Yaoundé, Cameroon.
Anthony MbonyeSchool of Public Health- Makerere University and Commissioner Health Services, Ministry of Health, Uganda.
Obinna OnwujekweDepartment of Pharmacology and Therapeutics, University of Nigeria Enugu-Campus, Nigeria.
Denise Roth AllenCenters for Disease Control and Prevention (CDC), USA.
Delér ShakelyDepartment of Microbiology, Tumour and Cell Biology, Karolinska Institute, Stockholm, Sweden.
Sarah StaedkeClinical Research Department, London School of Hygiene and Tropical Medicine, London, UK.
Lasse S VestergaardCentre for Medical Parasitology, University of Copenhagen and Copenhagen University Hospital Rigshospitalet, Denmark.
Christopher J M WhittyClinical Research Department, London School of Hygiene and Tropical Medicine, London, UK.
Virginia WisemanDepartment of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
Clare I R ChandlerDepartment of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
London School of Hygiene & Tropical Medicine · GBKarolinska Institutet · SECenters for Disease Control and Prevention · USLDS Business College · USMinistry of Health · UGStatens Serum Institut · DKUniversité de Yaoundé I · CMUniversity of California, Berkeley · USUniversity of Copenhagen · DKUniversity of Nigeria · NGUppsala University · SE

Funding

Medical Research Council MR/N003810/1
6 · The paper itself

Abstract

objectivesThe overuse of antimalarial drugs is widespread. Effective methods to improve prescribing practice remain unclear. We evaluated the impact of 10 interventions that introduced rapid diagnostic tests for malaria (mRDTs) on the use of tests and adherence to results in different contexts.

designA comparative case study approach, analysing variation in outcomes across different settings.

settingStudies from the ACT Consortium evaluating mRDTs with a range of supporting interventions in 6 malaria endemic countries. Providers were governmental or non-governmental healthcare workers, private retail sector workers or community volunteers. Each study arm in a distinct setting was considered a case.

participants28 cases from 10 studies were included, representing 148 461 patients seeking care for suspected malaria.

interventionsThe interventions included different mRDT training packages, supervision, supplies and community sensitisation. OUTCOME MEASURES: Analysis explored variation in: (1) uptake of mRDTs (% febrile patients tested); (2) provider adherence to positive mRDTs (%

resultsOutcomes varied widely across cases: 12-100% mRDT uptake; 44-98% adherence to positive mRDTs; 27-100% adherence to negative mRDTs. Providers appeared more motivated to perform well when mRDTs and intervention characteristics fitted with their own priorities. Goodness of fit of mRDTs with existing consultation and diagnostic practices appeared crucial to maximising the impact of mRDTs on care, as did prior familiarity with malaria testing; adequate human resources and supplies; possible alternative treatments for mRDT-negative patients; a more directive intervention approach and local preferences for ACTs.

conclusionsBasic training and resources are essential but insufficient to maximise the potential of mRDTs in many contexts. Programme design should respond to assessments of provider priorities, expectations and capacities. As mRDTs become established, the intensity of supporting interventions required seems likely to reduce.

Indexed as

Practice Patterns, Physicians'AntimalarialsArtemisininsDisease ManagementDrug PrescriptionsFeverGuideline AdherenceHealth PersonnelHumansMalariaPlasmodium falciparumPrescription Drug OveruseReagent Kits, DiagnosticSerologic TestsTime FactorsAntimalarialsartemisininArtemisininsReagent Kits, DiagnosticTROPICAL MEDICINE

Identifiers

PMID28274962
PMCPMC5353269
OpenAlexW2592598035

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.