Significant demand from general practitioners for inflammatory marker tests performed in clinical laboratories highlights an untapped opportunity for the use of point-of-care diagnostics in community settings, suggests research from the community healthcare medtech and in vitro diagnostics cooperative of the UK’s National Institute for Health Research. The recently published study finds that general practitioners typically request 36 C-reactive protein (CRP) tests and 72 neutrophil count tests each week.1
For the study, research teams from the University of Birmingham, the University of Oxford, and Katholieke Universiteit Leuven analyzed data about more than 1.14 million requests for CRP and neutrophil count tests from 69 general practices in Oxfordshire from 2014 through 2016. The requests involved more than 435,000 patients, and correspond to roughly one CRP test request per five people per year, and one neutrophil count test request per three people per year. More than 70% of those initially tested would require another test within a 3-year period.
CRP and neutrophil count are important biomarkers of inflammation used by general practitioners. CRP levels in the blood typically rise rapidly in response to infection and inflammatory conditions. An elevated neutrophil count indicates abnormal inflammation, which may result from acute bacterial infection; while a low neutrophil count can be a warning that a patient is at higher risk of serious bacterial infection, which can be a complication of treatments such as chemotherapy.
General practitioners often have to wait up to 24 hours to receive test results from central laboratories, despite the availability of existing point-of-care equivalents.
“Inflammatory marker laboratory tests are requested frequently in the community, particularly in combination, with many patients needing repeat tests,” says José Ordóñez-Mena, MSc, a medical statistician in the department of primary care health sciences at Oxford University and lead author of the study. “We also find that CRP test requests are becoming increasingly common in older patients. Given that these tests can now be provided by point-of-care technologies, there is scope for this testing to start moving into the community, carried out by general practitioners for results within minutes, rather than being performed by central laboratories.”
For further information, visit the National Institute for Health Research Community Healthcare Medtech and In Vitro Diagnostics Cooperative.
- Ordóñez-Mena JM, Fanshawe TR, McCartney D, et al. C-reactive protein and neutrophil count laboratory test requests from primary care: what is the demand and would substitution by point-of-care technology be viable? J Clin Pathol. Epub ahead of print, April 16, 2019; doi: 10.1136/jclinpath-2018-205688.
Featured image: Neutrophil cell in blood smear, analyzed by microscope. Photo © Jarun011 courtesy Dreamstime (ID 116883897).