Effect of point of care blood testing on physical health check completion in mental health services: mixed-methods evaluation
Butler J., de Cassan S., Glogowska M., Fanshawe T., Turner P., Lennox B., Hayward G.
<p><strong>Background:</strong> Physical health outcomes in severe mental illness are worse than in the general population. Routine physical health check completion in this cohort is poor.</p> <p><strong>Aims:</strong> To quantitatively and qualitatively evaluate the impact of ‘Point of Care’ (POC) blood testing on physical health check completion in two Community Mental Health Teams.</p> <p><strong>Methods:</strong> In a prospective cohort design, we equipped an Early Intervention Service (EIS) and a Community Mental Health Team (CMHT) with a POC device for six months. We compared rates of blood test and full physical health check completion in the intervention teams to a matched EIS and CMHT, historically and during the intervention. We explored attitudes to POC tests using thematic analysis of semi-structured interviews with patients and clinicians experiencing POC-augmented care.</p> <p><strong>Results:</strong> Whilst the CMHT did not utilise POC and saw no change in outcomes, direct comparison of testing rates in the intervention period showed the EIS had increased physical health check completion (RR=5.18 [CI=2.54 to 12.44] p<0.001) compared to controls. The rate was consistent with the EIS’s increasing rate of testing with time (RR= 0.45 [CI=0.09 to 2.08] p=0.32). Similar trends were seen inblood test completion. POC was acceptable to patients but clinicians reported usability, provision, and impact on the therapeutic relationship as barriers to POC test uptake.</p> <p><strong>Conclusions:</strong> POC was beneficial and acceptable to patients, and may increase physical health check uptake. Further research, accounting for clinician barriers is needed to evaluate POC-augmented care’s clinical and cost effectiveness.</p>