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A mathematical model for designing networks of C-Reactive Protein point of care testing

A mathematical model for designing networks of C-Reactive Protein point of care testing
A mathematical model for designing networks of C-Reactive Protein point of care testing
One approach to improving antibiotic stewardship in primary care may be to support all General Practitioners (GPs) to have access to point of care C-Reactive Protein tests to guide their prescribing decisions in patients presenting with symptoms of lower respiratory tract infection. However, to date there has been no work to understand how clinical commissioning groups might approach the practicalities of system-wide implementation. We aimed to develop an accessible service delivery modelling tool that, based on open data, could generate a layout of the geographical distribution of point of care facilities that minimised the cost and travel distance for patients across a given region. We considered different implementation models where point of care tests were placed at either GP surgeries, pharmacies or both. We analysed the trade-offs between cost and travel found by running the model under different configurations and analysing the model results in four regions of England (two urban, two rural). Our model suggests that even under assumptions of short travel distances for patients (e.g. under 500m), it is possible to achieve a meaningful reduction in the number of necessary point of care testing facilities to serve a region by referring some patients to be tested at nearby GP surgeries or pharmacies. In our test cases pharmacy-led implementation models resulted in some patients having to travel long distances to obtain a test, beyond the desired travel limits. These results indicate that an efficient implementation strategy for point of care tests over a geographic region, potentially building on primary care networks, might lead to significant cost reduction in equipment and associated personnel training, maintenance and quality control costs; as well as achieving fair access to testing facilities.
1932-6203
Lamas Fernandez, Carlos
e96b5deb-74d5-4c9b-a0ce-448c99526b09
Hayward, Gail
cdcca43f-3ee3-4094-a16b-a51b1585e9ed
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Monks, Thomas
ccaa21dc-b1fd-4b5a-b114-8c36f3107d40
Lamas Fernandez, Carlos
e96b5deb-74d5-4c9b-a0ce-448c99526b09
Hayward, Gail
cdcca43f-3ee3-4094-a16b-a51b1585e9ed
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Monks, Thomas
ccaa21dc-b1fd-4b5a-b114-8c36f3107d40

Lamas Fernandez, Carlos, Hayward, Gail, Moore, Michael and Monks, Thomas (2019) A mathematical model for designing networks of C-Reactive Protein point of care testing. PLoS ONE. (doi:10.1371/journal.pone.0222676).

Record type: Article

Abstract

One approach to improving antibiotic stewardship in primary care may be to support all General Practitioners (GPs) to have access to point of care C-Reactive Protein tests to guide their prescribing decisions in patients presenting with symptoms of lower respiratory tract infection. However, to date there has been no work to understand how clinical commissioning groups might approach the practicalities of system-wide implementation. We aimed to develop an accessible service delivery modelling tool that, based on open data, could generate a layout of the geographical distribution of point of care facilities that minimised the cost and travel distance for patients across a given region. We considered different implementation models where point of care tests were placed at either GP surgeries, pharmacies or both. We analysed the trade-offs between cost and travel found by running the model under different configurations and analysing the model results in four regions of England (two urban, two rural). Our model suggests that even under assumptions of short travel distances for patients (e.g. under 500m), it is possible to achieve a meaningful reduction in the number of necessary point of care testing facilities to serve a region by referring some patients to be tested at nearby GP surgeries or pharmacies. In our test cases pharmacy-led implementation models resulted in some patients having to travel long distances to obtain a test, beyond the desired travel limits. These results indicate that an efficient implementation strategy for point of care tests over a geographic region, potentially building on primary care networks, might lead to significant cost reduction in equipment and associated personnel training, maintenance and quality control costs; as well as achieving fair access to testing facilities.

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Accepted/In Press date: 3 September 2019
Published date: 17 September 2019

Identifiers

Local EPrints ID: 434975
URI: http://eprints.soton.ac.uk/id/eprint/434975
ISSN: 1932-6203
PURE UUID: c207b56e-2e78-4721-b01a-ce7192d5aa12
ORCID for Carlos Lamas Fernandez: ORCID iD orcid.org/0000-0001-5329-7619
ORCID for Michael Moore: ORCID iD orcid.org/0000-0002-5127-4509

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Date deposited: 17 Oct 2019 16:30
Last modified: 07 Feb 2024 03:00

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Contributors

Author: Carlos Lamas Fernandez ORCID iD
Author: Gail Hayward
Author: Michael Moore ORCID iD
Author: Thomas Monks

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