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      Implementing PCR testing in general practice—a qualitative study using normalization process theory

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          Abstract

          Background

          The COVID-19 pandemic brought attention to a need for rapid testing of large populations. Experiences from community-based testing settings show that there can be workload difficulties, logistical challenges and socioeconomic downsides to large scale Polymerase Chain Reaction (PCR) testing. Alternative testing arenas have therefore been considered. Rapid point-of-care (POC) PCR test methods have since been developed and could have potential to surveille viral respiratory infections. It is, however, unknown if PCR testing can be successfully implemented routinely in general practice. The aim of this study was to assess factors that enable and inhibit the implementation of point-of-care PCR testing for acute respiratory tract infection in general practice.

          Methods

          Fourteen general practices in the east Zealand area in Denmark were included in the study and given access to POC PCR testing equipment during a flu season. The participating clinics were initially trained in the use of a POC PCR testing device and then spent 6 weeks testing it. We conducted qualitative interviews with general practitioners (GPs) and their staff, before and after the testing period, specifically focusing on their clinical decision-making and internal collaboration in relation to POC PCR testing. We used normalization process theory to design the interview guides and to analyze the data.

          Results

          Professionals reported no clinical need for a POC PCR testing device in a non-pandemic clinical setting. Results were delivered faster, but this was only timesaving for the patient and not the GP, who had to perform more tasks.

          Conclusion

          In its current form, the added diagnostic value of using POC PCR testing in general practice was not sufficient for the professionals to justify the increased work connected to the usage of the diagnostic procedure in daily practice.

          Trial registration

          n/a.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12913-023-10355-4.

          Related collections

          Most cited references22

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          Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

          Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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            How Many Interviews Are Enough?: An Experiment with Data Saturation and Variability

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              Implementing, Embedding, and Integrating Practices: An Outline of Normalization Process Theory

              C. May, T Finch (2009)
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                Author and article information

                Contributors
                goverbeck@health.sdu.dk
                Journal
                BMC Health Serv Res
                BMC Health Serv Res
                BMC Health Services Research
                BioMed Central (London )
                1472-6963
                30 November 2023
                30 November 2023
                2023
                : 23
                : 1325
                Affiliations
                [1 ]Department of Public Health, University of Southern Denmark, Research Unit of General Practice, ( https://ror.org/03yrrjy16) Odense, Denmark
                [2 ]Department of Public Health, University of Copenhagen, Center for General Practice, ( https://ror.org/035b05819) Copenhagen, Denmark
                Author information
                http://orcid.org/0009-0007-3959-0625
                http://orcid.org/0000-0002-3612-1731
                http://orcid.org/0000-0001-8501-9453
                http://orcid.org/0000-0002-2041-2219
                http://orcid.org/0000-0002-1629-1864
                http://orcid.org/0000-0002-1740-1148
                Article
                10355
                10.1186/s12913-023-10355-4
                10687998
                38037044
                238a5f32-a815-453e-a8f5-2822431a88fc
                © The Author(s) 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 8 June 2023
                : 20 November 2023
                Funding
                Funded by: University Library of Southern Denmark
                Categories
                Research
                Custom metadata
                © BioMed Central Ltd., part of Springer Nature 2023

                Health & Social care
                implementation,poc pcr testing,evaluation,normalization process theory
                Health & Social care
                implementation, poc pcr testing, evaluation, normalization process theory

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