PrescQIPP

Use of the Point of Care ‘C - Reactive Protein’ (POC CRP) Testing As a Diagnostic Tool to Reduce Antimicrobial Prescribing and Resistance in Patients with Lower Respiratory Tract Infections (LRTI) in Primary Care (2019)

Swale CCG

Project Summary

The POC CRP testing is a technology used to quantify CRP in blood, serum or plasma using the QuikRead go instrument. The innovative aspects are that QuikRead go CRP has the potential to provide rapid results by point-of-care testing of a 20 microlitre blood sample, with a reading time of 2 minutes.

Point-of-care CRP tests have the potential to change current practice by informing the clinical decision to prescribe antibiotics for people with symptoms of respiratory tract infections during a primary care (GP)consultation. Tests that improve clinical decision-making in antibiotic prescribing have been found to support antimicrobial stewardship.

In June 2017, the antibiotics data for Swale CCG was analysed, three GP Practices who were either performing higher than CCG average and /or national average were selected for participation in the POC CRP testing pilot study for patients attending their clinics with LRTI. Two POC CRP analysers were taken on loan by the CCG as part of an initiative to reduce their antibiotics prescribing rates for LRTI in line with NICE Guidelines. The analysers were shared amongst the three GP Practices over a period of 6 months and their cumulatively prescribing rates, for this period, were compared with the previous year.

The patients included as part of this study received a POC CRP test as part of their consultation within the surgery during the pilot period based on set inclusion and exclusion criteria.

  • The pilot achieved an average decrease of 13% in the total antibiotics prescribed and an average decrease of 41% in the use of “High Risk Antibiotics”, for the three practices, when compared to the same period the previous year.
  • Also, 84% of patients that met the inclusion criteria for CRP testing were not prescribed any antibiotics.
  • There was evidence to show change in prescribing practice and compliance with the Delayed Antibiotics prescribing policy which accounted for 3% of all prescribing.
  • The use of POC CRP testing has also resulted in encouraging behaviour change and prescribing practice by allowing the prescribers to promote self- care advice and achieved a mean of 73% ( n=71) compliance across all three practices.