How point-of-care HbA_1c testing changes the behaviour of people with diabetes and clinicians - a qualitative study

To explore adults with diabetes and clinician views of point-of-care HbA_1c testing.

Adults with diabetes and HbA_1c ≥ 58 mmol/mol (7.5%) receiving HbA_1c point-of-care testing in primary care were invited to individual interviews. Participants were interviewed twice, once prior to point-of-care testing and once after 6 months follow-up. Clinicians were interviewed once. A thematic framework based on an a priori framework was used to analyse the data.

Fifteen participants (eight women, age range 30-70 years, two Asians, 13 white Europeans) were interviewed. They liked point-of-care testing and found the single appointment more convenient than usual care. Receiving the test result at the appointment helped some people understand how some lifestyle behaviours affected their control of diabetes and motivated them to change behaviours. Receiving an immediate test result reduced the anxiety some people experience when waiting for a result. People thought there was little value in using point-of-care testing for their annual review. Clinicians liked the point-of-care testing but expressed concerns about costs.

This work suggests that several features of point-of-care testing may encourage behavioural change. It helped some people to link their HbA_1c result to recent lifestyle behaviours, thereby motivating behavioural change and reinforcing healthy lifestyle choices.