Interviews with STI patients provide guidance for point-of care testing

A study of patient opinions and expectations about the potential use of point of care tests (POCTs) has found there is broad support for the introduction of these in sexually transmitted infection clinics, but that patients' willingness to wait for results can be more complex.

Researchers carried out interviews with clinicians and patients in six sexual health clinics in the UK as part of a programme investigating the design and implementation of instant tests in these settings.

The interviews with patients provided valuable information about how to introduce these facilities successfully to the clinics. While there was acceptability about how POCTs would speed up the overall time to treatment—reducing the need for a second or third visit after lab testing, some patients were doubtful about spending more time in clinic to await test results, particularly if a subsequent test might be needed. It emerged that those who were more anxious about their infection status, or who were already experiencing symptoms, would be more likely to accept longer waiting times if it would result in a confirmed diagnosis.

Patients reporting frequent healthcare visits often based their expectations and opinions of services and POCTS on previous visits; and patients also suggested they would be more likely to accept new POCT pathways being introduced if they had been given information about it prior to their visit.

Sexually transmitted infections continue to be a major public health concern in the UK with around 420,000 diagnoses annually in England alone. While lab-based testing is the 'gold standard', providing patients with results in about a week, some non-lab based testing diagnostics promise provision of results in around 30 minutes. It is thought that shortening the time between diagnosis of infection and treatment may reduce the burden of infection in the population; as well as having the added potential of increasing the likelihood of the correct treatment, and mitigating the spread of antimicrobial resistance.

The Precise programme is a collaboration between clinicians, epidemiologists, microbiologists, social scientists and industry experts to develop and evaluate the introduction of Point of Care tests for multiple STIs, including chlamydia, gonorrhea, and mycoplasma genitalia and trichomonas. A multiple STI test device would enable specific treatment for the correct infection.

Researcher Dr. Sebastian Fuller said: "We found that patients tend to 'self-assess' themselves as high- or low-risk when they visit clinics. Patients told us that if they had been involved in more risky behaviours they would express much more readiness to wait longer in clinic to get their result and treatment. Therefore we recommend implementing the POCTs initially in patients who identify themselves as being at high risk of infection."

The research has been published in PLOS ONE.