Point-of-care tests for sexually transmissible infections: what do ‘end users’ want?
Anne M. Rompalo A D , Yu-Hsiang Hsieh B , Terry Hogan A , Mathilda Barnes A , Mary Jett-Goheen A , Jill S. Huppert C and Charlotte A. Gaydos AA Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA.
B Department of Emergency Medicine, The Johns Hopkins School of Medicine, Baltimore, MD 21287, USA.
C Division of Pediatric and Adolescent Gynecology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA.
D Corresponding author. Email: arompalo@jhmi.edu
Submitted: 4 April 2013 Accepted: 2 September 2013 Published: 28 October 2013
Abstract
Background: Clinicians and developers identify sensitivity as an important quality in a point-of-care test (POCT) for sexually transmissible infections (STIs). Little information exists regarding what patients want for STI POCTs. Methods: A qualitative study, encompassing five focus groups among attendees of STI and adolescent health centres in Baltimore, Maryland, and Cincinnati, Ohio, were conducted between March 2008 and April 2009. Discussion topics included advantages and disadvantages of having a POCT, perceived barriers to using POCTs in the clinic setting and at home, priorities for the development of new POCTs for STIs, and envisioned characteristics of an ideal POCT. All discussions were recorded and transcribed. A qualitative content analysis was performed to examine frequencies or patterns of recurring codes, which were regrouped and indexed to identify salient themes. Results: Patients attending STI and adolescent outpatient clinics are in favour of diagnostic tests that are rapid, easy to read and simple to use. Home testing options for POCTs were acceptable and provided better confidentiality, privacy and convenience, but clinic-based POCTs were also acceptable because they offer definitive results and ensure immediate treatment. Barriers to home POCTs centred on cost and the ability to read and perform the test correctly at home. Opinions did not differ by patient ethnicity, except that Hispanic participants questioned the reliability of home test results, wanted high sensitivity and desired bilingual instructions. Conclusions: Patients attending STI and adolescent medical centres are in favour of STI POCTs if they are affordable, rapid, easy to read and simple to use.
Additional keywords: acceptability, clinic-based test, diagnostics, home-based test.
References
[1] Hsieh YH, Hogan MT, Barnes M, Jett-Goheen M, Huppert J, Rompalo AM, et al Perceptions of an ideal point-of-care test for sexually transmitted infections – a qualitative study of focus group discussions with medical providers. PLoS ONE 2010; 5 e14144| Perceptions of an ideal point-of-care test for sexually transmitted infections – a qualitative study of focus group discussions with medical providers.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3cXhsFelurnL&md5=9efd5fff2c8ce9c504434f92acfe5836CAS | 21152386PubMed |
[2] Hsieh YH, Gaydos CA, Hogan MT, Uy OM, Jackman J, Jett-Goheen M, et al What qualities are most important to making a point of care test desirable for clinicians and others offering sexually transmitted infection testing? PLoS ONE 2011; 6 e19263
| What qualities are most important to making a point of care test desirable for clinicians and others offering sexually transmitted infection testing?Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3MXlslGmtLg%3D&md5=7953c8dbc8a4fec39e1bb6a6f919f00cCAS | 21559435PubMed |
[3] Weigl BH, Gaydos CA, Kost G, Beyette FR, Sabourin S, Rompalo A, et al The value of clinical needs assessments for point-of-care diagnostics. Point of Care 2012; 11 108–13.
| 23935405PubMed |
[4] Satterwhite CL, Chow JM. Bernstein, Guerry SL, Nakatsukasa-Ono W, Bauer HM. Sexually transmitted infections among U.S. women and men: prevalence and incidence estimates, 2008. Sex Transm Dis 2013; 40 187–93.
| Bernstein, Guerry SL, Nakatsukasa-Ono W, Bauer HM. Sexually transmitted infections among U.S. women and men: prevalence and incidence estimates, 2008.Crossref | GoogleScholarGoogle Scholar | 23403598PubMed |
[5] Centers for Disease Control and Prevention (CDC). Sexually transmitted disease surveillance 2012. Atlanta: CDC; 2013.
[6] Kaiser Family Foundation (KFF). Sexual health of adolescents and young adults in the United States . Menlo Park: KFF; 2008.
[7] Hui BB, Wilson DP, Ward JS, Guy RJ, Kaldor JM, Law MG, et al The potential impact of new generation molecular point-of-care tests on gonorrhoea and chlamydia in a setting of high endemic prevalence. Sex Health 2013; 10 348–56.
| The potential impact of new generation molecular point-of-care tests on gonorrhoea and chlamydia in a setting of high endemic prevalence.Crossref | GoogleScholarGoogle Scholar | 23806149PubMed |
[8] Schwebke J, Sadler R, Sutton J, Hook EW. Positive screening tests for gonorrhea and chlamydial infection fail to lead consistently to treatment of patients attending a sexually transmitted disease clinic. Sex Transm Dis 1997; 24 181–4.
| Positive screening tests for gonorrhea and chlamydial infection fail to lead consistently to treatment of patients attending a sexually transmitted disease clinic.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2s3ls1aqtQ%3D%3D&md5=8e8279b18ba19e4d4bae3188cf7c1fc8CAS | 9101628PubMed |
[9] Swain G, McDonald R, Pfister J, Gradus M, Sedmak G, Singh A. Decision analysis: point-of-care chlamydia testing vs. laboratory-based methods. Clin Med Res 2004; 2 29–35.
| Decision analysis: point-of-care chlamydia testing vs. laboratory-based methods.Crossref | GoogleScholarGoogle Scholar | 15931332PubMed |
[10] Peeling RW, Holmes KK, Mabey D, Ronald A. Rapid tests for sexually transmitted infections (STIs): the way forward. Sex Transm Infect 2006; 82 v1–6.
| Rapid tests for sexually transmitted infections (STIs): the way forward.Crossref | GoogleScholarGoogle Scholar | 17151023PubMed |
[11] Peeling RW, Mabey DC. Point-of-care tests for diagnosing infections in the developing world. Clin Microbiol Infect 2010; 6 1062–9.
[12] Strasser S, Bitarakwate E, Gill M, Hoffman HJ, Musana O, Phiri A, et al Introduction of rapid syphilis testing within prevention of mother-to-child transmission of HIV programs in Uganda and Zambia: a field acceptability and feasibility study. J Acquir Immune Defic Syndr 2012; 61 e40–e46.
| Introduction of rapid syphilis testing within prevention of mother-to-child transmission of HIV programs in Uganda and Zambia: a field acceptability and feasibility study.Crossref | GoogleScholarGoogle Scholar | 22820810PubMed |
[13] Owusu-Edusei K, Gift TL, Ballard RC. Cost-effectiveness of a dual non-treponemal/treponemal syphilis point-of-care test to prevent adverse pregnancy outcomes in sub-Saharan Africa. Sex Transm Dis 2011; 38 997–1003.
| Cost-effectiveness of a dual non-treponemal/treponemal syphilis point-of-care test to prevent adverse pregnancy outcomes in sub-Saharan Africa.Crossref | GoogleScholarGoogle Scholar | 21992974PubMed |
[14] Hsieh YH, Gaydos CA, Hogan MT, Barnes M, Jett-Goheen M, Huppert J, et al Perceptions on point of care tests for sexually transmitted infections – comparison between frontline clinicians and professionals in industry. Point Care. 2012; 11 126–9.
| 22844231PubMed |
[15] Morgan D. The focus group guidebook. Thousand Oaks: Sage; 1998.
[16] Kitzinger J. Qualitative research. Introducing focus groups. BMJ 1995; 311 299–302.
| Qualitative research. Introducing focus groups.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2MzlvFOrug%3D%3D&md5=b9bbf652480ad6c05d6832adf76241c6CAS | 7633241PubMed |
[17] Powell R, Single H. Focus groups. Int J Qual Health Care 1996; 8 499–504.
| Focus groups.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2s7jsFKgsA%3D%3D&md5=3410beafa8eff1b6e48de22c9c6f9671CAS | 9117204PubMed |
[18] Hsieh H, Shannon S. Three approaches to qualitative content analysis. Qual Health Res 2005; 15 1277–88.
| Three approaches to qualitative content analysis.Crossref | GoogleScholarGoogle Scholar | 16204405PubMed |
[19] Rothman RE, Ketlogetswe KS, Dolan T, Wyer PC, Kelen GD. Preventive care in the emergency department: should emergency departments conduct routine HIV screening? A systematic review. Acad Emerg Med 2003; 10 278–85.
| Preventive care in the emergency department: should emergency departments conduct routine HIV screening? A systematic review.Crossref | GoogleScholarGoogle Scholar | 12615596PubMed |
[20] Prost A, Griffiths CJ, Anderson J. Feasibility and acceptability of offering rapid HIV tests to patients registering with primary care in London (UK): a pilot study. Sex Transm Infect 2009; 85 326–9.
| Feasibility and acceptability of offering rapid HIV tests to patients registering with primary care in London (UK): a pilot study.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1MnjvFOhsA%3D%3D&md5=6bef6307fef3ae83d0bf3ce4f9b2743dCAS | 19487214PubMed |
[21] Ashby J, Braithweaite B, Walsh J, Gnani S, Fidler S, Cooke G. HIV testing uptake and acceptability in an inner city polyclinic. AIDS Care 2012; 24 905–9.
| HIV testing uptake and acceptability in an inner city polyclinic.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC38vhtVyjtQ%3D%3D&md5=85a147a18dd335a96d2eda966745c7f2CAS | 22272938PubMed |
[22] Roth AM, Dodge BM, Van Der Pol B, Reece M, Zimet GD. Low acceptance of HSV-2 testing among high-risk women. Int J STD AIDS 2011; 22 329–31.
| Low acceptance of HSV-2 testing among high-risk women.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC3MnhtlOisQ%3D%3D&md5=21af45a4f3f7279424c5f612041d6818CAS | 21680668PubMed |
[23] Laurence CO, Gialamas A, Bubner T, Yelland L, Wilson K, Ryan P, et al Patient satisfaction with point-of-care testing in general practice. Br J Gen Pract 2010; 60 98–104.
| Patient satisfaction with point-of-care testing in general practice.Crossref | GoogleScholarGoogle Scholar |
[24] Huppert JS, Hesse EA, Bernard MA, Xiao Y, Huang B, Gaydos CA, et al Acceptability of self-testing for trichomoniasis increases with experience. Sex Transm Infect 2011; 87 494–500.
| Acceptability of self-testing for trichomoniasis increases with experience.Crossref | GoogleScholarGoogle Scholar | 21795289PubMed |
[25] Huppert JS, Hesse EA, Bernard MC, Bates JR, Gaydos CA, Kahn JA. Accuracy and trust of self-testing for bacterial vaginosis. J Adolesc Health 2012; 51 400–5.
| Accuracy and trust of self-testing for bacterial vaginosis.Crossref | GoogleScholarGoogle Scholar | 22999842PubMed |
