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Type: Journal article
Title: "I do feel like a scientist at times": A qualitative study of the acceptability of molecular point-of-care testing for chlamydia and gonorrhoea to primary care professionals in a remote high STI burden setting
Author: Natoli, L.
Guy, R.
Shephard, M.
Causer, L.
Badman, S.
Hengel, B.
Tangey, A.
Ward, J.
Coburn, T.
Anderson, D.
Kaldor, J.
Maher, L.
TTANGO Investigators
Citation: PLoS One, 2015; 10(12):e0145993-1-e0145993-17
Publisher: PLoS
Issue Date: 2015
ISSN: 1932-6203
Editor: Kumar, S.
Statement of
Lisa Natoli, Rebecca J. Guy, Mark Shephard, Louise Causer, Steven G. Badman, Belinda Hengel, Annie Tangey, James Ward, Tony Coburn, David Anderson, John Kaldor, Lisa Maher, TTANGO Investigators
Abstract: BACKGROUND:Point-of-care tests for chlamydia (CT) and gonorrhoea (NG) could increase the uptake and timeliness of testing and treatment, contribute to improved disease control and reduce reproductive morbidity. The GeneXpert (Xpert CT/NG assay), suited to use at the point-of-care, is being used in the TTANGO randomised controlled trial (RCT) in 12 remote Australian health services with a high burden of sexually transmissible infections (STIs). This represents the first ever routine use of a molecular point-of-care diagnostic for STIs in primary care. The purpose of this study was to explore the acceptability of the GeneXpert to primary care staff in remote Australia. METHODS:In-depth qualitative interviews were conducted with 16 staff (registered or enrolled nurses and Aboriginal Health Workers/Practitioners) trained and experienced with GeneXpert testing. Interviews were digitally-recorded and transcribed verbatim prior to content analysis. RESULTS:Most participants displayed positive attitudes, indicating the test was both easy to use and useful in their clinical context. Participants indicated that point-of-care testing had improved management of STIs, resulting in more timely and targeted treatment, earlier commencement of partner notification, and reduced follow up efforts associated with client recall. Staff expressed confidence in point-of-care test results and treating patients on this basis, and reported greater job satisfaction. While point-of-care testing did not negatively impact on client flow, several found the manual documentation processes time consuming, suggesting that improved electronic connectivity and test result transfer between the GeneXpert and patient management systems could overcome this. Managing positive test results in a shorter time frame was challenging for some but most found it satisfying to complete episodes of care more quickly. CONCLUSIONS:In the context of a RCT, health professionals working in remote primary care in Australia found the GeneXpert highly acceptable. These findings have implications for use in other primary care settings around the world.
Keywords: TTANGO Investigators
Chlamydia Infections
Specimen Handling
Power (Psychology)
Job Satisfaction
Time Factors
Unnecessary Procedures
Primary Health Care
Quality Assurance, Health Care
Point-of-Care Testing
Rights: © 2015 Natoli et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
DOI: 10.1371/journal.pone.0145993
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