Exploration of reasons for primary care testing (the Why Test study): a UK-wide audit using the Primary care Academic CollaboraTive.
blood tests
clinical decision-making
collaborative research
diagnosis
overtesting
primary health care
Journal
The British journal of general practice : the journal of the Royal College of General Practitioners
ISSN: 1478-5242
Titre abrégé: Br J Gen Pract
Pays: England
ID NLM: 9005323
Informations de publication
Date de publication:
14 Jul 2023
14 Jul 2023
Historique:
received:
18
04
2023
accepted:
05
07
2023
medline:
3
10
2023
pubmed:
3
10
2023
entrez:
2
10
2023
Statut:
aheadofprint
Résumé
Rates of blood testing have increased over the past two decades. Reasons for testing cannot easily be extracted from electronic health record databases. To explore who requests blood tests and why, and what the outcomes of testing are in UK primary care. A retrospective audit of electronic health records in general practices in England, Wales, Scotland, and Northern Ireland was undertaken. Fifty-seven clinicians from the Primary care Academic CollaboraTive (PACT) each reviewed the electronic health records of 50 patients who had blood tests in April 2021. Anonymised data were extracted including patient characteristics, who requested the tests, reasons for testing, test results, and outcomes of testing. Data were collected from 2572 patients across 57 GP practices. The commonest reasons for testing in primary care were investigation of symptoms (43.2%), monitoring of existing disease (30.1%), monitoring of existing medications (10.1%), and follow up of previous abnormalities (6.8%); patient requested testing was rare in this study (1.5%). Abnormal and borderline results were common, with 26.6% of patients having completely normal test results. Around one-quarter of tests were thought to be partially or fully unnecessary when reviewed retrospectively by a clinical colleague. Overall, 6.2% of tests in primary care led to a new diagnosis or confirmation of a diagnosis. The utilisation of a national collaborative model (PACT) has enabled a unique exploration of the rationale and outcomes of blood testing in primary care, highlighting areas for future research and optimisation.
Sections du résumé
BACKGROUND
BACKGROUND
Rates of blood testing have increased over the past two decades. Reasons for testing cannot easily be extracted from electronic health record databases.
AIM
OBJECTIVE
To explore who requests blood tests and why, and what the outcomes of testing are in UK primary care.
DESIGN AND SETTING
METHODS
A retrospective audit of electronic health records in general practices in England, Wales, Scotland, and Northern Ireland was undertaken.
METHOD
METHODS
Fifty-seven clinicians from the Primary care Academic CollaboraTive (PACT) each reviewed the electronic health records of 50 patients who had blood tests in April 2021. Anonymised data were extracted including patient characteristics, who requested the tests, reasons for testing, test results, and outcomes of testing.
RESULTS
RESULTS
Data were collected from 2572 patients across 57 GP practices. The commonest reasons for testing in primary care were investigation of symptoms (43.2%), monitoring of existing disease (30.1%), monitoring of existing medications (10.1%), and follow up of previous abnormalities (6.8%); patient requested testing was rare in this study (1.5%). Abnormal and borderline results were common, with 26.6% of patients having completely normal test results. Around one-quarter of tests were thought to be partially or fully unnecessary when reviewed retrospectively by a clinical colleague. Overall, 6.2% of tests in primary care led to a new diagnosis or confirmation of a diagnosis.
CONCLUSION
CONCLUSIONS
The utilisation of a national collaborative model (PACT) has enabled a unique exploration of the rationale and outcomes of blood testing in primary care, highlighting areas for future research and optimisation.
Identifiants
pubmed: 37783511
pii: BJGP.2023.0191
doi: 10.3399/BJGP.2023.0191
pmc: PMC10562996
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© The Authors.
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