Evidence map›Paper›PMID 34272866›Full record

ArticleAge and ageing2021

Enhanced lateral flow testing strategies in care homes are associated with poor adherence and were insufficient to prevent COVID-19 outbreaks: results from a mixed methods implementation study.

John S P Tulloch, Massimo Micocci, Peter Buckle, Karen Lawrenson, Patrick Kierkegaard, Anna McLister, Adam L Gordon, Marta García-Fiñana, Steve Peddie, Matthew Ashton and 2 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Age and ageing, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 3 pooled it
2.0field-weighted citation impact, top 11% 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

22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 36 citations in OpenAlex.

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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

12 authors at 4 institutions in 3 countries.

John S P TullochInstitute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool CH64 7TE, UK.ORCID 0000-0003-2150-0090
Massimo MicocciNIHR London In Vitro Diagnostics Co-operative, Department of Surgery and Cancer, Imperial College London, London W2 1NY, UK.
Peter BuckleNIHR London In Vitro Diagnostics Co-operative, Department of Surgery and Cancer, Imperial College London, London W2 1NY, UK.
Karen LawrensonPublic Health Department, Liverpool City Council, Liverpool L3 1DS, UK.
Patrick KierkegaardNIHR London In Vitro Diagnostics Co-operative, Department of Surgery and Cancer, Imperial College London, London W2 1NY, UK.ORCID 0000-0001-8600-7956
Anna McListerNIHR London In Vitro Diagnostics Co-operative, Department of Surgery and Cancer, Imperial College London, London W2 1NY, UK.
Adam L GordonDivision of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Nottingham, UK.
Marta García-FiñanaInstitute of Population Health, University of Liverpool, Liverpool, UK.
Steve PeddieAdults Social Care Department, Liverpool City Council, Liverpool L3 1DS, UK.
Matthew AshtonPublic Health Department, Liverpool City Council, Liverpool L3 1DS, UK.
Iain BuchanInstitute of Population Health, University of Liverpool, Liverpool, UK.
Paula ParvulescuPublic Health Department, Liverpool City Council, Liverpool L3 1DS, UK.
Liverpool City Council · GBNIHR Leeds In Vitro Diagnostics Co-operative · GBUniversity of Liverpool · GBUniversity of Nottingham · GB

Funding

Department of Health
6 · The paper itself

Abstract

introductionCare homes have been severely affected by the SARS-CoV-2 pandemic. Rapid antigen testing could identify most SARS-CoV-2 infected staff and visitors before they enter homes. We explored implementation of staff and visitor testing protocols using lateral flow devices (LFDs).

methodsAn evaluation of a SARS-CoV-2 LFD-based testing protocol in 11 care homes in Liverpool, UK, including staff and visitor testing, plus a qualitative exploratory study in nine of these homes. The proportion of pilot homes with outbreaks, and outbreak size, were compared to non-pilot homes in Liverpool. Adherence to testing protocols was evaluated. Fifteen staff were interviewed, and transcript data were thematically coded using an iterative analysis to identify and categorize factors influencing testing implementation.

resultsIn total, 1,638 LFD rapid tests were performed on 407 staff. Protocol adherence was poor with 8.6% of staff achieving >75% protocol adherence, and 25.3% achieving $\ge$50%. Six care homes had outbreaks during the study. Compared to non-pilot care homes, there was no evidence of significant difference in the proportion of homes with outbreaks, or the size of outbreaks. Qualitative data showed difficulty implementing testing strategies due to excessive work burden. Factors influencing adherence related to test integration and procedural factors, socio-economic factors, cognitive overload and the emotional value of testing.

conclusionImplementation of staff and visitor care home LFD testing protocols was poorly adhered to and consequently did not reduce the number or scale of COVID-19 outbreaks. More focus is needed on the contextual and behavioural factors that influence protocol adherence.

Indexed as

COVID-19COVID-19 TestingDisease OutbreaksHumansPandemicsSARS-CoV-2antigen testcare homesCOVID-19lateral flow devicesrapid point-of-care testingSARS-CoV-2

Identifiers

PMID34272866
PMCPMC8406873
OpenAlexW3177755229

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.