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AMBULATORY CARE

Point-of-Care Testing: An Introduction

Clinical Assistant Professor, College of Pharmacy, Department of Clinical and Administrative Sciences, The University of Oklahoma, Tulsa, OK

Timothy E Welty, PharmD FCCP BCPS

Associate Professor, McWhorter School of Pharmacy, Samford University, Birmingham, AL

Reprints: Sheryl L Gutierres PharmD, College of Pharmacy, The University of Oklahoma, Department of Clinical and Administrative Sciences, Schusterman Center, 4502 East 41st St., Suite 1H29, Tulsa, OK 74135-2512, fax 918/660-3580, sheryl-gutierres{at}ouhsc.edu

OBJECTIVE: To review available literature and provide perspective on point-of-care testing, focusing on the impact it has on treatment outcomes in patient care, the impact it has on the costs of patient care, and the role it has in the delivery of pharmaceutical care.

DATA SOURCES: Information was retrieved from MEDLINE English literature searches using PubMed (1965–August 2003) and included search terms of point-of-care testing, near patient testing, pharmaceutical care, pharmacists, outcomes, and economics. Additionally, references from retrieved articles were reviewed to identify literature not detected by literature searches.

STUDY SELECTION AND DATA EXTRACTION: Comparative studies, demonstration project reports, and systematic reviews were selected. Other related resources, such as government documents, relevant legislation, and government regulations, were included. Emphasis was placed on comparative studies and demonstration project reports. In the absence of these data, other resources were included.

DATA SYNTHESIS: Point-of-care testing devices and technology are increasingly used in the delivery of care and therapeutic decision making. No studies have evaluated the impact of point-of-care testing, by itself, on patient care and outcomes. All studies have incorporated point-of-care testing with changes in the way patient care is delivered and have shown significant improvements when this approach is taken. The cost of point-of-care testing is greater than traditional laboratory testing, but the increased cost may be offset by improvements in the management of patient care, improvements in patient outcomes, and decreased utilization of the healthcare system. Point-of-care testing has been used successfully by pharmacists in disease management programs. Various government regulations and legislation impact the use of point-of-care testing.

CONCLUSIONS: Limited data indicate that point-of-care testing, when combined with changes in healthcare delivery systems, may improve patient outcomes and decrease the overall cost of health care. Pharmacists have used point-of-care testing in programs designed to improve patient care but must carefully consider regulations and laws that govern the use of these devices. There is a great need for additional investigation into the use of point-of-care testing in patient care.

Key Words: ambulatory care, Clinical Laboratory Improvement Amendments, point-of-care testing

Published Online, December 5, 2003. www.theannals.com, DOI 10.1345/aph.1D212

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