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  1. Article ; Online: The societal impact of implementing an at-home blood sampling device for chronic care patients: patient preferences and cost impact.

    Lingervelder, Deon / Kip, Michelle M A / Wiese, Eva D / Koffijberg, Hendrik / Ijzerman, Maarten J / Kusters, Ron

    BMC health services research

    2022  Volume 22, Issue 1, Page(s) 1529

    Abstract: Background: Diabetes mellitus, cardiovascular diseases, chronic kidney disease, and thyroid diseases are chronic diseases that require regular monitoring through blood tests. This paper first investigates the experiences of chronic care patients with ... ...

    Abstract Background: Diabetes mellitus, cardiovascular diseases, chronic kidney disease, and thyroid diseases are chronic diseases that require regular monitoring through blood tests. This paper first investigates the experiences of chronic care patients with venipuncture and their expectations of an at-home blood-sampling device, and then assesses the impact on societal costs of implementing such a device in current practice.
    Methods: An online survey was distributed among chronic care patients to gain insight into their experience of blood sampling in current practice, and their expectations of an at-home blood-sampling device. The survey results were used as input parameters in a patient-level monte carlo analysis developed to represent a hypothetical cohort of Dutch chronically ill patients to investigate the impact on societal costs compared to usual care.
    Results: In total, 1311 patients participated in the survey, of which 31% experience the time spent on the phlebotomy appointment as a burden. Of all respondents, 71% prefer to use an at-home blood-sampling device to monitor their chronic disease. The cost analysis indicated that implementing an at-home blood-sampling device increases the cost of phlebotomy itself by €27.25 per patient per year, but it reduces the overall societal costs by €24.86 per patient per year, mainly due to limiting productivity loss.
    Conclusions: Patients consider an at-home blood-sampling device to be more user-friendly than venous phlebotomy on location. Long waiting times and crowded locations can be avoided by using an at-home blood-sampling device. Implementing such a device is likely cost-saving as it is expected to reduce societal costs.
    Language English
    Publishing date 2022-12-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 2050434-2
    ISSN 1472-6963 ; 1472-6963
    ISSN (online) 1472-6963
    ISSN 1472-6963
    DOI 10.1186/s12913-022-08782-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Health Economic Evidence of Point-of-Care Testing: A Systematic Review.

    Lingervelder, Deon / Koffijberg, Hendrik / Kusters, Ron / IJzerman, Maarten J

    PharmacoEconomics - open

    2021  Volume 5, Issue 2, Page(s) 157–173

    Abstract: Objective: Point-of-care testing (POCT) has become an essential diagnostic technology for optimal patient care. Its implementation, however, still falls behind. This paper reviews the available evidence on the health economic impact of introducing POCT ... ...

    Abstract Objective: Point-of-care testing (POCT) has become an essential diagnostic technology for optimal patient care. Its implementation, however, still falls behind. This paper reviews the available evidence on the health economic impact of introducing POCT to assess if poor POCT uptake may be related to lacking evidence.
    Study design: The Scopus and PubMed databases were searched to identify publications describing a health economic evaluation of a point-of-care (POC) test. Data were extracted from the included publications, including general and methodological characteristics as well as the study results summarized in either cost, effects or an incremental cost-effectiveness ratio. Results were sorted into six groups according to the POC test's purpose (diagnosis, screening or monitoring) and care setting (primary care or secondary care). The reporting quality of the publications was determined using the CHEERS checklist.
    Results: The initial search resulted in 396 publications, of which 44 met the inclusion criteria. Most of the evaluations were performed in a primary care setting (n = 31; 70.5%) compared with a secondary care setting (n = 13; 29.5%). About two thirds of the evaluations were on POC tests implemented with a diagnostic purpose (n = 28; 63.6%). More than 75% of evaluations concluded that POCT is recommended for implementation, although in some cases only under specific circumstances and conditions. Compliance with the CHEERS checklist items ranged from 20.8% to 100%, with an average reporting quality of 72.0%.
    Conclusion: There were very few evaluations in this review that advised against the implementation of POCT. However, the uptake of POCT in many countries remains low. Even though the evaluations included in this review did not always include the full long-term benefits of POCT, it is clear that health economic evidence across a few dimensions of value already indicate the benefits of POCT. This suggests that the lack of evidence on POCT is not the primary barrier to its implementation and that the low uptake of these tests in clinical practice is due to (a combination of) other barriers. In this context, aspects around organization of care, support of clinicians and quality management may be crucial in the widespread implementation of POCT.
    Language English
    Publishing date 2021-01-06
    Publishing country Switzerland
    Document type Systematic Review
    ZDB-ID 2874287-4
    ISSN 2509-4254 ; 2509-4262
    ISSN (online) 2509-4254
    ISSN 2509-4262
    DOI 10.1007/s41669-020-00248-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Point-of-care testing in primary care: A systematic review on implementation aspects addressed in test evaluations.

    Lingervelder, Deon / Koffijberg, Hendrik / Kusters, Ron / IJzerman, Maarten J

    International journal of clinical practice

    2019  Volume 73, Issue 10, Page(s) e13392

    Abstract: Objectives: There are numerous point-of-care tests (POCTs) available on the market, but many of these are not used. This study reviewed literature pertaining to the evaluation/usage of POCTs in primary care, to investigate whether outcomes being ... ...

    Abstract Objectives: There are numerous point-of-care tests (POCTs) available on the market, but many of these are not used. This study reviewed literature pertaining to the evaluation/usage of POCTs in primary care, to investigate whether outcomes being reported reflect aspects previously demonstrated to be important for general practitioners (GPs) in the decision to implement a POCT in practice.
    Methods: Scopus and Medline were searched to identify studies that evaluated a POCT in primary care. We identified abstracts and full-texts consisting of applied studies (eg trials, simulations, observational studies) and qualitative studies (eg interviews, surveys). Data were extracted from the included studies, such as the type of study, the extent to which manufacturers were involved in the study, and the biomarker/assay measured by the test(s). Studies were evaluated to summarise the extent to which they reported on, amongst others, clinical utility, user-friendliness, turnaround-time and technical performance (aspects previously identified as important).
    Results: The initial search resulted in 1398 publications, of which 125 met the inclusion criteria. From these studies, 83 POCTs across several disease areas (including cardiovascular disease, venous thromboembolism and respiratory-tract-infections) were identified. There was an inconsistency between what is reported in the studies and what GPs consider important. GPs perceive clinical utility as the most important aspect, yet this was rarely included explicitly in test evaluations in the literature, with only 8% of evaluations incorporating it in their analysis/discussion.
    Conclusions: This review showed that, despite the growing market and development of new POCTs, studies evaluating such tests fail to report on aspects that GPs find important. To ensure that an evaluation of a POCT is useful to primary care clinicians, future evaluations should not only focus on the technical performance aspects of a test, but also report on the aspects relating to the clinical utility and risks.
    MeSH term(s) General Practitioners ; Health Plan Implementation ; Humans ; Point-of-Care Testing/statistics & numerical data ; Practice Patterns, Physicians'/statistics & numerical data ; Primary Health Care/statistics & numerical data ; Respiratory Tract Infections/diagnosis
    Keywords covid19
    Language English
    Publishing date 2019-08-19
    Publishing country England
    Document type Journal Article ; Systematic Review
    ZDB-ID 1386246-7
    ISSN 1742-1241 ; 1368-5031
    ISSN (online) 1742-1241
    ISSN 1368-5031
    DOI 10.1111/ijcp.13392
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: How to Realize the Benefits of Point-of-Care Testing at the General Practice

    Deon Lingervelder / Hendrik Koffijberg / Jon D. Emery / Paul Fennessy / Christopher P. Price / Harm van Marwijk / Torunn B. Eide / Sverre Sandberg / Jochen Cals / Joke Derksen / Ron Kusters / Maarten J. IJzermanx

    International Journal of Health Policy and Management, Vol 11, Iss 10, Pp 2248-

    A Comparison of Four High-Income Countries

    2022  Volume 2260

    Abstract: Background In some countries, such as the Netherlands and Norway, point-of-care testing (POCT) is more widely implemented in general practice compared to countries such as England and Australia. To comprehend what is necessary to realize the benefits of ... ...

    Abstract Background In some countries, such as the Netherlands and Norway, point-of-care testing (POCT) is more widely implemented in general practice compared to countries such as England and Australia. To comprehend what is necessary to realize the benefits of POCT, regarding its integration in primary care, it would be beneficial to have an overview of the structure of healthcare operations and the transactions between stakeholders (also referred to as value networks). The aim of this paper is to identify the current value networks in place applying to POCT implementation at general practices in England, Australia, Norway and the Netherlands and to compare these networks in terms of seven previously published factors that support the successful implementation, sustainability and scale-up of innovations.Methods The value networks were described based on formal guidelines and standards published by the respective governments, organizational bodies and affiliates. The value network of each country was validated by at least two relevant stakeholders from the respective country.Results The analysis revealed that the biggest challenge for countries with low POCT uptake was the lack of effective communication between the several organizations involved with POCT as well as the high workload for general practitioners (GPs) aiming to implement POCT. It is observed that countries with a single national authority responsible for POCT have a better uptake as they can govern the task of POCT roll-out and management and reduce the workload for GPs by assisting with set-up, quality control, training and support.Conclusion Setting up a single national authority may be an effective step towards realizing the full benefits of POCT. Although it is possible for day-to-day operations to fall under the responsibility of the GP, this is only feasible if support and guidance are readily available to ensure that the workload associated with POCT is limited and as low as possible.
    Keywords primary healthcare ; general practice ; value network ; rapid diagnostics ; organization of care ; Public aspects of medicine ; RA1-1270
    Subject code 360
    Language English
    Publishing date 2022-10-01T00:00:00Z
    Publisher Kerman University of Medical Sciences
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: How to Realize the Benefits of Point-of-Care Testing at the General Practice: A Comparison of Four High-Income Countries.

    Lingervelder, Deon / Koffijberg, Hendrik / Emery, Jon D / Fennessy, Paul / Price, Christopher P / van Marwijk, Harm / Eide, Torunn B / Sandberg, Sverre / Cals, Jochen W L / Derksen, Joke T M / Kusters, Ron / IJzerman, Maarten J

    International journal of health policy and management

    2021  Volume 11, Issue 10, Page(s) 2248–2260

    Abstract: Background: In some countries, such as the Netherlands and Norway, point-of-care testing (POCT) is more widely implemented in general practice compared to countries such as England and Australia. To comprehend what is necessary to realize the benefits ... ...

    Abstract Background: In some countries, such as the Netherlands and Norway, point-of-care testing (POCT) is more widely implemented in general practice compared to countries such as England and Australia. To comprehend what is necessary to realize the benefits of POCT, regarding its integration in primary care, it would be beneficial to have an overview of the structure of healthcare operations and the transactions between stakeholders (also referred to as value networks). The aim of this paper is to identify the current value networks in place applying to POCT implementation at general practices in England, Australia, Norway and the Netherlands and to compare these networks in terms of seven previously published factors that support the successful implementation, sustainability and scale-up of innovations.
    Methods: The value networks were described based on formal guidelines and standards published by the respective governments, organizational bodies and affiliates. The value network of each country was validated by at least two relevant stakeholders from the respective country.
    Results: The analysis revealed that the biggest challenge for countries with low POCT uptake was the lack of effective communication between the several organizations involved with POCT as well as the high workload for general practitioners (GPs) aiming to implement POCT. It is observed that countries with a single national authority responsible for POCT have a better uptake as they can govern the task of POCT roll-out and management and reduce the workload for GPs by assisting with set-up, quality control, training and support.
    Conclusion: Setting up a single national authority may be an effective step towards realizing the full benefits of POCT. Although it is possible for day-to-day operations to fall under the responsibility of the GP, this is only feasible if support and guidance are readily available to ensure that the workload associated with POCT is limited and as low as possible.
    MeSH term(s) Humans ; Developed Countries ; General Practice ; Point-of-Care Testing ; Family Practice ; General Practitioners
    Language English
    Publishing date 2021-10-13
    Publishing country Iran
    Document type Journal Article
    ZDB-ID 2724317-5
    ISSN 2322-5939 ; 2322-5939
    ISSN (online) 2322-5939
    ISSN 2322-5939
    DOI 10.34172/ijhpm.2021.143
    Database MEDical Literature Analysis and Retrieval System OnLINE

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