Do point-of-care tests (POCTs) offer a new paradigm for the management of patients with influenza?

Abstract

Although point-of-care tests (POCTs) for influenza have been available for 20 years, the implementation of this technology in the United Kingdom (UK) has been slow due to problems with the sensitivity of the tests and how to integrate them into the care pathways. However, with the more recent expansion of the second generation nucleic acid amplification POC technologies, with improved sensitivity to the comparable ‘gold standard’ PCR laboratory tests, the implementation of these has become more acceptable in clinical settings.

While theoretically POCTs themselves could be performed at home, this application is not within the scope of this article. The definition of POCTs here is restricted to platforms with the potential to be used within 20 metres of patients and operated by a wide range of staff, including those without a laboratory background. The time to result may vary from 10 to 90 minutes [1]. This article will not cover the various tests that are available or diagnostic accuracies of these compared with the ‘gold standard’, as other published studies have covered this in depth [2,3].

From the literature, there has been successful use of the POCTs within hospital settings [4,5], paediatric emergency departments [6], community pharmacy settings [7] and outpatient departments [8]. This evidence and (more recent) experiences of others [9] suggest that there now may be an opportunity to change the way patients who present with acute respiratory symptoms are managed and to use POCTs as part of a healthcare pathway. This Perspective article aims to explore the opportunities and challenges of their introduction with a public health focus and provides an opinion on how they can be successfully and thoughtfully implemented into routine healthcare.

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http://creativecommons.org/licenses/by/4.0/

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DOI

https://doi.org/10.2807/1560-7917.ES.2020.25.44.1900420