Rapid testing and treatment for sexually transmitted infections improve patient care and yield public health benefits

With collaborators at Chelsea and Westminster NHS Foundation Trust, we estimated the impact of a rapid testing and result notification service for patients testing for sexually transmitted infections at the Dean Street Express clinic. We found that a rapid testing service for asymptomatic infections resulted in 8 days’ faster time to result notification for CT and/or NG which enables faster treatment, thus reducing infectious periods and leading to fewer transmissions, unnecessary partner attendances and clinic costs, compared with those attending an existing ‘standard’ sexual health clinic.

PublicationGary G Whitlock, Daniel C Gibbons, Nick Longford, Michael J Harvey, Alan McOwan, Elisabeth J Adams Rapid testing and treatment for sexually transmitted infections improve patient care and yield public health benefits
International Journal of STD & AIDS. First Published October 23, 2017
https://doi.org/10.1177/0956462417736431

 

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How to prevent cervical cancer: HPV – we are coming to get you!

Prevention of cervical cancer in women is the focus of vaccination and screening programmes globally. However, there is no consensus on the best way to approach screening, and screening across Europe varies considerably. Innovations in diagnostic testing and new ways to engage women in screening may improve screening uptake and increase the efficiency of screening pathways. In this talk, we explore opportunities for a rapid or point of care test for HPV as part of the screening pathway, and how self-sampling may be an effective way to engage women in screening.

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Adams EJ. How to prevent cervical cancer: HPV – we are coming to get you! EUROGIN. June 15-18, 2016. Salzburg, Austria.

 

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Estimating the clinical impact and costs of implementing a point of care test for influenza A/B and respiratory syncytial virus on an acute paediatric hospital inpatient ward

We explored the impact of introducing a high performance point of care test (POCT) for influenza and respiratory syncytial virus (RSV) on an acute paediatric ward of a large London hospital during influenza season compared to standard care of using a laboratory-based test. We estimated the outcomes before and after implementing a POCT (Enigma® MiniLab™ FluAB-RSV test) for paediatric patients admitted to an acute respiratory ward in the 2013/14 and 2014/15 respiratory seasons. There was a significant reduction in reimbursement charges for influenza- and RSV-negative patients, for the full hospital stay and the period on the acute paediatric ward after implementing the POCT, however, these differences disappeared when controlling for top-up service charges. More appropriate treatment of patients with influenza occurred after implementing the POCT (40% versus 13% received oseltamivir, p=0.02). There was no difference in length of stay between the two periods. Findings indicate cost savings for commissioners and hospitals, even without a reduction in the length of stay.

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Vecino-Ortiz AI, Glover RE, Douthwaite ST, et al.
Estimating the clinical impact and costs of implementing a point of care test for influenza A/B and respiratory syncytial virus on an acute paediatric hospital inpatient ward. Society for Medical Decision Making. 12-14 June 2016. London, UK.

 

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A rapid influenza test in hospitals could avoid unnecessary paediatric isolation bed days and save costs

We created a decision tree to estimate the unnecessary isolation days averted by early diagnosis of false positive patients with a point of care test for influenza compared to presumptive isolation and standard laboratory testing (12 versus 2 hours’ time to results). Assuming a 7% prevalence of influenza in a cohort of 300 patients with suspected influenza, average hospital stay of 3 days, and the cost of an isolation bed being 10% more than a ward bed, using a point of care test could avert 80-95% of the unnecessary isolation days, with an associated estimated cost savings of roughly £7000-£9000, depending on if they test were implemented on the ward or in A&E, respectively. Point of care tests could improve bed management and reduce unnecessary isolation days and the associated costs, and reduce hospital transmission of infection.

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Vecino-Ortiz AI, Glover RE, Rabe AJ, et al. A rapid influenza test in hospitals could avoid unnecessary paediatric isolation bed days and save cost. Society for Medical Decision Making. 12-14 June 2016. London, UK.

 

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