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Point-of-Care Testing in Diabetes Management: What Role Does It Play?

Address correspondence and requests for reprints to: Dr. Judith Belle Brown, Centre for Studies in Family Medicine, 100 Collip Circle, Suite 245, London, Ontario, Canada, N6G 4X8.

Diabetes is a multisystem disease requiring complex management provided by a variety health care professionals (HCPs). Comprehensive care of patients with diabetes requires frequent testing of hemoglobin A_1c (A1C), and research indicates that use of point-of-care testing (POCT) can affect patients' A1C results in the shortterm. The purpose of this qualitative study was to explore the ideas, opinions, and expectations of HCPs and patients with diabetes about the potential role of POCT, including its impact on patient-provider interactions, patient care, and issues of implementation.

In-depth interviews, which were audiotaped and transcribed verbatim, were conducted with key stakeholders. The analysis used immersion and crystalization strategies. Thirty-seven interviews were conducted: seven with endocrinologists and internists, seven with family physicians, eight with diabetes educators, seven with family practice nurses, and eight with patients with diabetes.

Two major themes emerged from the data analysis: 1) the impact of POCT on the clinical encounter and the care of patients, and 2) the POCT machine, including accuracy and the cost of incorporating the machine into clinical practice. The analysis revealed strong similarities across all groups of HCPs, and patients also expressed similar concerns.

This study illuminates perceptions of HCPs and patients regarding the impact of POCT on diabetes management. POCT was viewed as having many benefits in the clinical care of patients with diabetes, including face-to-face encounters that offer immediate feedback, proactive patient education, increased collaboration between patients and providers, and improved patient adherence. However, logistical issues, such as the machine's accuracy and cost factors, could be significant barriers to implementation

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