Work

Respiratory multi-viral rapid-antigen point-of-care tests in New Zealand primary care: a mixed-methods pilot

Year: 2025

Type: article

Abstract: Background Rapid, cost-effective diagnosis of acute respiratory infections is now possible using multi-viral rapid-antigen point-of-care tests (MVRA-POCTs) with high sensitivity and specificity. These offer a realistic alternative to polymerase chain reaction tests in primary care. However, evidence of acceptability and clinical utility in this setting is limited. Aim To pilot feasibility of integrating MVRA-POCTs into routine primary care, and investigate patient and clinician attitudes and behaviours. Design & setting A prospective mixed-methods pilot study in seven New Zealand (NZ) primary care clinics during winter 2023. Method Patients with acute respiratory symptoms received an MVRA-POCT (instead of COVID-19-only). Outcomes and acceptability were assessed via audits of electronic medical records, clinician and patient surveys, and interviews and focus groups with patients and clinic staff. Results Swab results were recorded from a demographically diverse cohort of 1754 patients; 14% tested positive for any virus ( n = 246/1754). All clinicians and most patients surveyed positively evaluated the test. All clinicians incorporated the MVRA-POCT into practice and found it useful. In total, 63% of prescribers ( n = 26/41) reported results influenced antibiotic prescribing; 12% ( n = 5/41) supported decisions about secondary care referrals for 12% ( n = 5/41). All patient responders who tested positive ( n = 39) and most testing negative ( n = 172/180, 96%) would like the MVRA-POCT in future. Patients testing positive self-reported as more likely to follow non-pharmaceutical interventions to reduce transmission compared with those testing negative. Conclusion MVRA-POCTs were well-accepted and readily incorporated into practice. Routine integration into primary care could potentially improve management of common respiratory illnesses and promote patient behaviour change to reduce transmission.

Source: BJGP Open

DOI: 10.3399/bjgpo.2025.0108