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Feasibility of C-reactive protein point-of-care testing for antibiotic stewardship in rural GP-pharmacy settings
Sajal Kumar Saha1,2, Michael Muleme2, Oliver Van Hecke3
1Centre for Innovation in Infectious Disease and Immunology Research (CIIDIR), Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC, Australia.
Objective:
To assess the feasibility of implementing C-reactive protein point-of-care testing (CRP-PoCT) for patients presenting with respiratory tract infections (RTIs) in primary care.
Design:
Feasibility study.
Setting:
General practice (GP) and community pharmacy in rural Victoria.
Patients Or Participants:
Five GPs and a community pharmacist used CRP-PoCT for RTI patients aged 12-65 years for two months between August and December 2023.
Methods:
Data on testing, prescribing, and implementation barriers and facilitators were collected from patient records and surveys of GPs and pharmacists. Feasibility outcomes were analyzed using descriptive statistics and content analysis.
Results:
Fifty-five patients were screened, with recruitment rates of 87.5% (35/40) in GP clinics and 67% (10/15) in community pharmacies, and a retention rate of 100%. Adherence to the testing protocol was 100% in both settings; however, adherence to the prescribing protocol was 76% in GP practices and 100% in pharmacies. Common RTI symptoms were cough (70%, n = 30), fever (58%, n = 25), and sore throat (44%, n = 19). Antibiotics were prescribed to 36.4% (12/33) of GP patients and 10% (1/10) of pharmacy patients. Pharmacists managed patients with OTC medicines (80%, 8/10) or immediate GP referral (10%, 1/10). CRP-PoCT feasibility was rated highly by GPs [median 6/7 (IQR 4-6)] and moderately by the pharmacist (4/7). Key implementation facilitators identified were nurse/technician support, medicare funding, clear workflows, and GP-pharmacy collaborative practice agreement.
Conclusion:
With mitigation of practical challenges, CRP-PoCT can be feasibly implemented in rural GP-pharmacy settings to enhance antibiotic stewardship for acute respiratory infections in primary care.
