Recommended point-of-care tests in out-of-hours primary care: A modified Delphi study

Background Point-of-care tests (POCTs) are increasingly used to enhance diagnostic accuracy and facilitate rapid clinical decision-making in settings with limited laboratory access. However, there is currently no consensus on which POCTs should be routinely available in out-of-hours (OOH) primary care services. Aim To establish expert consensus on which POCTs should be considered essential or optional in European OOH primary care services. Design and Setting A modified Delphi consensus study involving an international panel of experts from 20 European countries, representing diverse clinical and academic backgrounds in OOH primary care. Method A three-round Delphi process was conducted. Round 1 assessed current POCT availability via questionnaire. In Round 2, panellists rated 28 POCTs as essential, optional, or unnecessary. In Round 3, results were discussed in a structured in-person workshop, followed by anonymous re-voting. Consensus was predefined as ≥66.6% agreement. Results Six POCTs achieved consensus as essential: blood glucose, urine dipstick, C-reactive protein (CRP), pregnancy testing, electrocardiography (ECG), and haemoglobin measurement. Twelve tests were classified as optional, while ten were deemed unnecessary. Key concerns included inappropriate use, variability in clinician confidence, and patient-driven demand. Conclusion This study provides the first European consensus on POCT prioritisation in OOH primary care. Implementation of essential POCTs, supported by training and governance, may improve diagnostic efficiency, while optional tests should be tailored to local service needs.