AI Article Synopsis
- C-reactive protein point-of-care testing (CRP POCT) is being studied for its effectiveness and cost-efficiency in guiding antibiotic prescriptions for nursing home residents diagnosed with lower respiratory tract infections (LRTI).
- The study was conducted in 11 nursing homes in the Netherlands, involving 241 residents, comparing POCT-guided care to standard care without the use of CRP testing.
- Findings indicated that while POCT-guided care led to a higher cost per patient, it significantly reduced antibiotic prescribing; however, it did not notably affect recovery rates, suggesting a need for careful consideration of its investment versus benefits.
Article Abstract
Objectives: C-reactive protein point-of-care testing (CRP POCT) is a promising diagnostic tool to guide antibiotic prescribing for lower respiratory tract infections (LRTI) in nursing home residents. This study aimed to evaluate cost-effectiveness and return-on-investment (ROI) of CRP POCT compared with usual care for nursing home residents with suspected LRTI from a healthcare perspective.
Design: Economic evaluation alongside a cluster randomised, controlled trial.
Setting: 11 Dutch nursing homes.
Participants: 241 nursing home residents with a newly suspected LRTI.
Intervention: Nursing home access to CRP POCT (POCT-guided care) was compared with usual care without CRP POCT (usual care).
Main Outcome Measures: The primary outcome measure for the cost-effectiveness analysis was antibiotic prescribing at initial consultation, and the secondary outcome was full recovery at 3 weeks. ROI analyses included intervention costs, and benefits related to antibiotic prescribing. Three ROI metrics were calculated: Net Benefits, Benefit-Cost-Ratio and Return-On-Investment.
Results: In POCT-guided care, total costs were on average €32 higher per patient, the proportion of avoided antibiotic prescribing was higher (0.47 vs 0.18; 0.30, 95% CI 0.17 to 0.42) and the proportion of fully recovered patients statistically non-significantly lower (0.86 vs 0.91; -0.05, 95% CI -0.14 to 0.05) compared with usual care. On average, an avoided antibiotic prescription was associated with an investment of €137 in POCT-guided care compared with usual care. Sensitivity analyses showed that results were relatively robust. Taking the ROI metrics together, the probability of financial return was 0.65.
Conclusion: POCT-guided care effectively reduces antibiotic prescribing compared with usual care without significant effects on recovery rates, but requires an investment. Future studies should take into account potential beneficial effects of POCT-guided care on costs and health outcomes related to antibiotic resistance.
Trial Registration Number: NL5054.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9478864 | PMC |
| http://dx.doi.org/10.1136/bmjopen-2021-055234 | DOI Listing |
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