Evaluation of the implementation process of POC-CRP devices in managing adults with cough in general practice: insights from a focus group study. - 2026
Acute cough; Ambulatory care; Antibiotic stewardship; Antibiotics; C-reactive protein (CRP); General practice; General practitioners; Infections; Point-of-care testing (POCT); Primary care
Disciplines :
General & internal medicine
Author, co-author :
Dankaerts, Annelien; Leuven Unit for Health Technology Assessment Research (LUHTAR), Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium. annelien.dankaerts@kuleuven.be ; Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium. annelien.dankaerts@kuleuven.be
Goeman, Stefanie; Faculty of Medicine, KU Leuven, Leuven, Belgium
Digregorio, Marina ; Université de Liège - ULiège > Département des sciences cliniques > Médecine générale
Willemsens, Frauke; Faculty of Medicine, KU Leuven, Leuven, Belgium
Vermetten, Lauren; Faculty of Medicine, KU Leuven, Leuven, Belgium
Van Hoovels, Lieve; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium ; Department of Laboratory Medicine, AZORG Hospital, Aalst, Belgium
Verbakel, Jan Y; Leuven Unit for Health Technology Assessment Research (LUHTAR), Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium ; Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
Language :
English
Title :
Evaluation of the implementation process of POC-CRP devices in managing adults with cough in general practice: insights from a focus group study.
Ten threats to global health. in 2019. Available from: https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019. Cited 2024 Nov 19.
Antimicrobial resistance. Available from: https://www.who.int/europe/news-room/fact-sheets/item/antimicrobial-resistance. Cited 2024 Nov 19.
Huemer M, Mairpady Shambat S, Brugger SD, Zinkernagel AS. Antibiotic resistance and persistence—Implications for human health and treatment perspectives. EMBO Rep. 2020;21(12):e51034.
Murray CJ Ikuta KS Sharara F Swetschinski L Robles Aguilar G Gray A et al. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis Lancet 2022 399 10325 629 55 1:CAS:528:DC%2BB38XpvFGrtb0%3D 10.1016/S0140-6736(21)02724-0
Jim O’Neill. Antimicrobial Resistance: Tackling a crisis for the health and wealth of nations. Available from: https://amr-review.org/sites/default/files/AMR%20Review%20Paper%20-%20Tackling%20a%20crisis%20for%20the%20health%20and%20wealth%20of%20nations_1.pdf. Cited 2024 Nov 20.
Aslam B Wang W Arshad MI Khurshid M Muzammil S Rasool MH et al. Antibiotic resistance: a rundown of a global crisis Infect Drug Resist 2018 11 1645 58 1:CAS:528:DC%2BC1MXitVyqtL3N 10.2147/IDR.S173867 30349322 6188119
Klein EY Van Boeckel TP Martinez EM Pant S Gandra S Levin SA et al. Global increase and geographic convergence in antibiotic consumption between 2000 and 2015 Proc Natl Acad Sci U S A 2018 115 15 E3463 70 1:CAS:528:DC%2BC1cXht1Gqt7jM 10.1073/pnas.1717295115 29581252 5899442
Costelloe C, Metcalfe C, Lovering A, Mant D, Hay AD. Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: Systematic review and meta-analysis. BMJ (Online). 2010;340:c2096.
Ecdc. Antimicrobial consumption in the EU/EEA (ESAC-Net) - Annual epidemiological report for 2024.
Llor C Bjerrum L Antimicrobial resistance: Risk associated with antibiotic overuse and initiatives to reduce the problem Ther Adv Drug Saf 2014 5 6 229 41 10.1177/2042098614554919 25436105 4232501
Webster KE, Parkhouse T, Dawson S, Jones HE, Brown EL, Hay AD et al. Diagnostic accuracy of point-of-care tests for acute respiratory infection: a systematic review of reviews. Health Technol Assess. 2024;1–75.
Hek K Van Esch TEM Lambooij A Weesie YM Van Dijk L Guideline Adherence in Antibiotic Prescribing to Patients with Respiratory Diseases in Primary Care: Prevalence and Practice Variation Antibiot (Basel) 2020 9 9 571 1:CAS:528:DC%2BB3cXisFCmtrvE 10.3390/antibiotics9090571
Tyrstrup M van der Velden A Engstrom S Goderis G Molstad S Verheij T et al. Antibiotic prescribing in relation to diagnoses and consultation rates in Belgium, the Netherlands and Sweden: use of European quality indicators Scand J Prim Health Care 2017 35 1 10 8 10.1080/02813432.2017.1288680 28277045 5361413
Whaley LE, Businger AC, Dempsey PP, Linder JA. Visit complexity, diagnostic uncertainty, and antibiotic prescribing for acute cough in primary care: a retrospective study. BMC Fam Pract. 2013;14:120.
AMR. Operationeel plan | FOD Volksgezondheid. Available from: https://www.health.belgium.be/nl/amr-operationeel-plan. Cited 2024 Nov 19.
Martínez-González NA Keizer E Plate A Coenen S Valeri F Verbakel JYJ et al. Point‐of‐care c‐reactive protein testing to reduce antibiotic prescribing for respiratory tract infections in primary care: Systematic review and meta‐analysis of randomised controlled trials Antibiotics 2020 9 9 1 31 10.3390/antibiotics9090610
Van Hecke O, Bjerrum L, Gentile I, Hopstaken R, Melbye H, Plate A et al. Guidance on C-reactive protein point-of-care testing and complementary strategies to improve antibiotic prescribing for adults with lower respiratory tract infections in primary care. Front Med (Lausanne). 2023;10:1166742.
Sproston NR, Ashworth JJ. Role of C-reactive protein at sites of inflammation and infection. Front Immunol. 2018;9:754.
Leticia Fernandez-Carballo B Escadafal C MacLean E Kapasi AJ Dittrich S Distinguishing bacterial versus non-bacterial causes of febrile illness – A systematic review of host biomarkers J Infect 2021 82 4 1 10 1:CAS:528:DC%2BB3MXlvVSrt7o%3D 10.1016/j.jinf.2021.01.028 33610683
Verbakel JY, Lee JJ, Goyder C, Tan PS, Ananthakumar T, Turner PJ et al. Impact of point-of-care C reactive protein in ambulatory care: A systematic review and meta-analysis. BMJ Open. 2019;9(1):e025036.
Bertoli G Ronzoni N Silva R Spinicci M Perlini C Omega L et al. Usefulness of C-Reactive Protein and Other Host BioMarker Point-of-Care Tests in the Assessment of Non-Malarial Acute Febrile Illnesses: A Systematic Review with Meta-Analysis Am J Trop Med Hyg 2020 103 5 1797 802 1:CAS:528:DC%2BB38XhslOnsbnN 10.4269/ajtmh.19-0935 32901594 7646768
Cooke J, Llor C, Hopstaken R, Dryden M, Butler C. Respiratory tract infections (RTIs) in primary care: Narrative review of C reactive protein (CRP) point-of-care testing (POCT) and antibacterial use in patients who present with symptoms of RTI. BMJ Open Respir Res. 2020;7(1):e000624.
Tonkin-Crine SKG, Tan PS, van Hecke O, Wang K, Roberts NW, Mccullough A et al. Clinician-targeted interventions to influence antibiotic prescribing behaviour for acute respiratory infections in primary care: An overview of systematic reviews. Cochrane Database Syst Reviews. 2017;(9):CD012252.
Smedemark SA, Llor C, Aabenhus R, Fournaise A, Jørgensen KJ, Olsen O. Biomarkers as point-of-care tests to guide prescription of antibiotics in people with acute respiratory infections in primary care. Cochrane Database Syst Reviews. 2022;10(10):CD010130.
Little P Stuart B Francis N Douglas E Tonkin-Crine S Anthierens S et al. Effects of internet-based training on antibiotic prescribing rates for acute respiratory-tract infections: a multinational, cluster, randomised, factorial, controlled trial Lancet 2013 382 9899 1175 10.1016/S0140-6736(13)60994-0 23915885 3807804
Oppong R Jit M Smith RD Butler CC Melbye H Mölstad S et al. Cost-effectiveness of point-of-care C-reactive protein testing to inform antibiotic prescribing decisions Br J Gen Pract 2013 63 612 10.3399/bjgp13X669185
Acuut hoesten | NHG-Richtlijnen. Available from: https://richtlijnen.nhg.org/standaarden/acuut-hoesten. Cited 2024 Nov 20.
van der Velden AW, van de Pol AC, Bongard E, Cianci D, Aabenhus R, Balan A et al. Point-of care testing, antibiotic prescribing, and prescribing confidence for respiratory tract infections in primary care: a prospective audit in 18 European countries. BJGP Open. 2022;6(2):BJGPO.2021.0212.
John AS Hopstaken R Tirimacco R Audehm R Price CP Analysis Implementing point-of-care CRP testing for better diagnosis of acute respiratory infections Br J Gen Pract 2022 72 715 87 8 10.3399/bjgp22X718517
Dewez JE, Nijman RG, Fitchett EJA, Lynch R, de Groot R, van der Flier M et al. Adoption of C-reactive protein point-of-care tests for the management of acute childhood infections in primary care in the Netherlands and England: a comparative health systems analysis. BMC Health Serv Res. 2023;23(1):191.
Hamilton AB, Finley EP. Qualitative methods in implementation research: An introduction. Psychiatry Res. 2019;280:112516.
Focus Groups: A Practical Guide for Applied Research - Richard, Krueger A. Mary Anne Casey - Google Boeken. Available from: Available from: https://www.perlego.com/book/4604969/focus-groups-a-practical-guide-for-applied-research-pdf. Cited 2024 Nov 20.
Braun V Clarke V Using thematic analysis in psychology Qual Res Psychol 2006 3 2 77 101 10.1191/1478088706qp063oa
Braun V Clarke V Reflecting on reflexive thematic analysis Qual Res Sport Exerc Health 2019 11 4 589 97 10.1080/2159676X.2019.1628806
von der Gracht HA Consensus measurement in Delphi studies: Review and implications for future quality assurance Technol Forecast Soc Change 2012 79 8 1525 36 10.1016/j.techfore.2012.04.013
Birt L Scott S Cavers D Campbell C Walter F Member Checking: A Tool to Enhance Trustworthiness or Merely a Nod to Validation? Qual Health Res 2016 26 13 1802 11 10.1177/1049732316654870 27340178
Lloyd N, Hyett N, Kenny A. To Member Check or not to Member Check? An Evaluation of Member Checking in an Interpretive Descriptive Study. Int J Qualitative Methods. 2024;23:1–10.
Jones CH Howick J Roberts NW Price CP Heneghan C Plüddemann A et al. Primary care clinicians’ attitudes towards point-of-care blood testing: a systematic review of qualitative studies BMC Fam Pract 2013 14 117 10.1186/1471-2296-14-117 23945264 3751354
Hardy V, Thompson M, Keppel GA, Alto W, Dirac MA, Neher J et al. Qualitative study of primary care clinicians’ views on point-of-care testing for C-reactive protein for acute respiratory tract infections in family medicine. BMJ Open. 2017;7(1):e012503.
Butler CC Simpson S Wood F General practitioners’ perceptions of introducing near-patient testing for common infections into routine primary care: A qualitative study Scand J Prim Health Care 2008 26 1 17 21 10.1080/02813430701726285 18297558 3406622
Wood F Brookes-howell L Hood K Cooper L Verheij T Goossens H et al. A multi-country qualitative study of clinicians’ and patients’ views on point of care tests for lower respiratory tract infection Fam Pract 2011 28 6 661 9 10.1093/fampra/cmr031 21653924
Cals JWL Butler CC Hopstaken RM Hood K Dinant GJ Effect of point of care testing for C reactive protein and training in communication skills on antibiotic use in lower respiratory tract infections: Cluster randomised trial BMJ (Online) 2009 338 7703 1112 5
D’hulster E, Digregorio M, De Burghgraeve T, Luyten J, Coenen S, Anthierens S et al. Behavioural impact of antibiotic stewardship in children in primary care: interviews with GPs and parents. JAC Antimicrob Resist. 2024;6(6):dlae207.
Schot MJC, Broekhuizen BDL, Cals JWL, Brussee E, de Wit NJ, Verheij TJM et al. C-reactive protein point-of-care testing in children with cough: qualitative study of GPs’ perceptions. BJGP Open. 2018;1(4):bjgpopen17X101193.
Schot MJC, Van den Bruel A, Broekhuizen BDL, Cals JWL, Noteboom EA, Balemans W et al. Point-of-care C-reactive protein to assist in primary care management of children with suspected non-serious lower respiratory tract infection: A randomised controlled trial. BJGP Open. 2018;2(3):bjgpopen18X101600.
Markwart R, Lehmann LS, Krause M, Jung P, Rost L, Doepfmer S et al. Utilisation and consequences of CRP point-of-care-testing in primary care practices: a real-world multicentre observational study with 1740 patient cases in Germany. BJGP. 2025;9(1):BJGPO.2024.0120.
Van Den Bruel A Jones C Thompson M Mant D C-reactive protein point-of-care testing in acutely ill children: a mixed methods study in primary care Arch Dis Child 2016 101 4 382 5 10.1136/archdischild-2015-309228 26757989
Huddy JR, Ni MZ, Barlow J, Majeed A, Hanna GB. Point-of-care C reactive protein for the diagnosis of lower respiratory tract infection in NHS primary care: a qualitative study of barriers and facilitators to adoption. BMJ Open 2016;6(3): e009959.
Jung BP, Doepfmer J, Heintze S, Krause C, Kuempel M et al. BJGP OPEN Evaluation of utilization and consequences of CRP point-of-care-testing in primary care practices: qualitative interviews with general practitioners from Germany. BJGP. 2025;9(1): BJGPO.2024.0076.
Hoste ME Borek AJ Santillo M Roberts N Tonkin-Crine S Anthierens S Point-of-care tests to manage acute respiratory tract infections in primary care: a systematic review and qualitative synthesis of healthcare professional and patient views J Antimicrob Chemother 2025 80 1 29 46 1:CAS:528:DC%2BB2MXptlCgt7w%3D 10.1093/jac/dkae349 39378128 11695907
Bjerrum L Gahrn-Hansen B Munck AP General practitioners who use CRP have a lower antibiotic prescribing rate to patients with sinusitis–secondary publication Ugeskr Laeger 2005 167 25–31 2775 7 16014265
Van Hoof V Barglazan D Blairon L Braekevelt B Debois R De Vos NVJ et al. Organisation and quality monitoring for point-of-care testing (POCT) in Belgium: proposal for an expansion of the legal framework for POCT into primary health care Acta Clin Belgica: Int J Clin Lab Med 2022 77 2 329 36 10.1080/17843286.2020.1868906
