Perspectives of clinicians caring for people experiencing homelessness on point of care tests: an online survey.
Rose F., Ukwatte U., Singh N., Turner PJ., Willcox M., Lennox B., Hayward GN.
OBJECTIVES: People experiencing homelessness (PEH) face multiple barriers to seeking healthcare and have poorer health outcomes. Point of care tests (POCTs) provide a potential solution to improving access to diagnostics for this population. This survey aimed to understand if these technologies could address unmet needs in primary care for PEH. DESIGN AND SETTING: An online survey was circulated via dedicated inclusion healthcare newsletters to professionals providing community-based care for PEH in England. The survey focused on experiences of diagnostics and opinions on the use of POCTs for this population. PARTICIPANTS: Thirty-two healthcare workers participated, including GPs, nurses and other allied practitioners from 13 different Integrated Care Boards across England. ANALYSIS: Descriptive analyses were performed using standard statistical parameters. A reflexive thematic analysis was performed on free-text responses. RESULTS: There was evidence of current POCT use but with marked variation across services as to which tests are available. Healthcare workers were overwhelmingly positive about the potential for POCTs, with rapid results facilitating prompt diagnosis and management, increasing likelihood of engagement. C reactive protein testing was considered as the test, which could confer the most benefit to acute care, with renal function and troponin also being discussed, whereas tests to determine cardiometabolic risk were thought to have the most patient benefit in chronic care. Point of care ultrasound for diagnosis of respiratory pathologies and deep vein thrombosis and POCTs for malnutrition were suggested as potential future technologies to address unmet healthcare needs. CONCLUSION: The majority of responders expressed that enhancing the provision of POCTs would be beneficial, both in acute and chronic care scenarios, due to the benefits of getting rapid results and reducing the need for repeat appointments or onward referral for diagnostics.