Evidence map›Paper›PMID 37327029›Full record

ArticleJMIR research protocols2023

The Impact of Point-of-Care Testing for Influenza on Antimicrobial Stewardship (PIAMS) in UK Primary Care: Protocol for a Mixed Methods Study.

Uy Hoang, Alice Williams, Jessica Smylie, Carole Aspden, Elizabeth Button, Jack Macartney, Cecilia Okusi, Rachel Byford, Filipa Ferreira, Meredith Leston and 5 more

Open access · goldAbstract read
In one paragraph

Article in JMIR research protocols, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 25% 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

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
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

15 authors at 4 institutions in 1 country.

Uy HoangNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.ORCID https://orcid.org/0000-0002-8428-5140
Alice WilliamsNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.ORCID https://orcid.org/0000-0003-4612-1468
Jessica SmylieNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.ORCID https://orcid.org/0000-0001-5036-9197
Carole AspdenNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.ORCID https://orcid.org/0000-0002-4467-1602
Elizabeth ButtonNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.ORCID https://orcid.org/0000-0003-0777-2508
Jack MacartneyNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.ORCID https://orcid.org/0000-0003-0678-2659
Cecilia OkusiNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.ORCID https://orcid.org/0000-0002-5575-8527
Rachel ByfordNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.ORCID https://orcid.org/0000-0002-4792-8995
Filipa FerreiraNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.ORCID https://orcid.org/0000-0003-0083-4809
Meredith LestonNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.ORCID https://orcid.org/0000-0003-0891-714X
Charis Xuan XieWolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.ORCID https://orcid.org/0000-0002-0029-9159
Mark JoyNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.ORCID https://orcid.org/0000-0002-4974-3724
Gemma MarsdenRoyal College of General Practitioners, London, United Kingdom.ORCID https://orcid.org/0000-0001-8710-1071
Tristan ClarkSchool of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.ORCID https://orcid.org/0000-0001-6026-5295
Simon de LusignanNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.ORCID https://orcid.org/0000-0002-8553-2641
University of Oxford · GBNational Health Service · GBQueen Mary University of London · GBRoyal College of General Practitioners · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMolecular point-of-care testing (POCT) used in primary care can inform whether a patient presenting with an acute respiratory infection has influenza. A confirmed clinical diagnosis, particularly early in the disease, could inform better antimicrobial stewardship. Social distancing and lockdowns during the COVID-19 pandemic have disturbed previous patterns of influenza infections in 2021. However, data from samples taken in the last quarter of 2022 suggest that influenza represents 36% of sentinel network positive virology, compared with 24% for respiratory syncytial virus. Problems with integration into the clinical workflow is a known barrier to incorporating technology into routine care.

objectiveThis study aims to report the impact of POCT for influenza on antimicrobial prescribing in primary care. We will additionally describe severe outcomes of infection (hospitalization and mortality) and how POCT is integrated into primary care workflows.

methodsThe impact of POCT for influenza on antimicrobial stewardship (PIAMS) in UK primary care is an observational study being conducted between December 2022 and May 2023 and involving 10 practices that contribute data to the English sentinel network. Up to 1000 people who present to participating practices with respiratory symptoms will be swabbed and tested with a rapid molecular POCT analyzer in the practice. Antimicrobial prescribing and other study outcomes will be collected by linking information from the POCT analyzer with data from the patient's computerized medical record. We will collect data on how POCT is incorporated into practice using data flow diagrams, unified modeling language use case diagrams, and Business Process Modeling Notation.

resultsWe will present the crude and adjusted odds of antimicrobial prescribing (all antibiotics and antivirals) given a POCT diagnosis of influenza, stratifying by whether individuals have a respiratory or other relevant diagnosis (eg, bronchiectasis). We will also present the rates of hospital referrals and deaths related to influenza infection in PIAMS study practices compared with a set of matched practices in the sentinel network and the rest of the network. We will describe any difference in implementation models in terms of staff involved and workflow.

conclusionsThis study will generate data on the impact of POCT testing for influenza in primary care as well as help to inform about the feasibility of incorporating POCT into primary care workflows. It will inform the design of future larger studies about the effectiveness and cost-effectiveness of POCT to improve antimicrobial stewardship and any impact on severe outcomes. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/46938.

Indexed as

acute respiratory infectionantimicrobialantimicrobial stewardshipgeneral practicehealth careimplementationinfluenzainfluenza point-of-care systemsmedical records systems, computerizedoutcome assessmentprimary carerespiratory symptomRSV

Identifiers

PMID37327029
PMCPMC10337326
OpenAlexW4378077942

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.