HIQA (23rd May, 2019) has published a HTA on C-reactive protein point-of-care testing (CRP POCT) to guide antibiotic prescribing for acute respiratory tract infections (RTIs) in primary care.

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HIQA, HTA of C-reactive protein point-of-care testing to guide antibiotic prescribing for RTIs in Primary Care

HIQA (23rd May, 2019) has published a HTA on C-reactive protein point-of-care testing (CRP POCT) to guide antibiotic prescribing for acute respiratory tract infections (RTIs) in primary care. Inappropriate antibiotic consumption is associated with increased antimicrobial resistance, which causes increased illness and death from bacterial infections. Approximately 2.4m prescriptions are issued for RTIs in Ireland per year. CRP POCT could significantly reduce that number.

Background In February 2018, the Health Information and Quality Authority (HIQA) commenced work on a health technology assessment (HTA) in relation to C-reactive protein point-of-care testing (CRP POCT). HIQA agreed to undertake the HTA following a formal request from the Lead of the Primary Care Clinical Programme in the Health Service Executive (HSE). The aim of the HTA was to establish the clinical and economic impact of providing point-of-care testing to inform antibiotic prescribing for patients presenting with symptoms of acute respiratory tract infections (RTIs) in primary care. This request was endorsed by the Department of Health and was included in the 2018 HIQA HTA work plan

 

Press Release (23rd May, 2019)

The Health Information and Quality Authority (HIQA) has today published a health technology assessment recommending that, as part of the wider effort to improve antimicrobial stewardship in Ireland, a carefully managed and monitored pilot programme of C-reactive protein point-of-care testing (CRP POCT) in primary care settings be considered by the Minister for Health.

Ireland has a high rate of antibiotic prescribing in patients presenting to primary care with acute respiratory tract infections (RTIs). Inappropriate antibiotic consumption is associated with increased antimicrobial resistance, causing increased illness and death from bacterial infections.

CRP POCT is used to measure the level of C-reactive protein in a person's blood, which can be used as an indicator of bacterial infection. Clinical trials have demonstrated that the use of CRP POCT in primary care settings to inform antibiotic prescribing for acute RTIs leads to a significant reduction in antibiotic prescribing without compromising patient safety.

HIQA's Chief Scientist, Dr Conor Teljeur, said: 'The use of CRP POCT in primary care settings to inform antibiotic prescribing for acute respiratory tract infections may lead to a significant reduction in antibiotic prescribing without compromising patient safety. The adoption of CRP POCT would also have organisational implications for general practices in terms of impact on patient flow, the need for quality assurance, and potential displacement of activity through longer consultation times for patients who undergo the test.'

An estimated 2.4 million prescriptions are issued for respiratory tract infections in Ireland each year – a number that could be halved if GPs used CRP POCT and were also provided with training directed at facilitating conversations with their patients about appropriate antibiotic prescribing.

Dr Teljeur continued: 'We need to determine how best to maintain the positive effects of CRP POCT over the longer term. A carefully managed and monitored pilot programme or partial roll-out of CRP POCT offers the best prospect to evaluate a CRP POCT programme and establish whether a national roll-out is advisable. CRP POCT should be considered within the context of a suite of initiatives to improve antimicrobial stewardship – it is essential that a multifaceted approach continues to be taken in managing antimicrobial resistance.'

The Health Technology Assessment of C-reactive protein point-of-care testing to guide antibiotic prescribing for acute respiratory tract infections in primary care settings was approved by the Board of HIQA last week and has been submitted to the Minister for Health for his consideration. The HTA is available on www.hiqa.ie, and includes an executive summary and a plain English summary.

For more information:

https://bit.ly/2JvMKCp

Attached Documents