IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0265173.html
   My bibliography  Save this article

Facilitators and barriers for clinical implementation of a 30-minute point-of-care test for Neisseria gonorrhoeae and Chlamydia trachomatis into clinical care: A qualitative study within sexual health services in England

Author

Listed:
  • Agata Pacho
  • Emma M Harding-Esch
  • Emma G Heming De-Allie
  • Laura Phillips
  • Martina Furegato
  • S Tariq Sadiq
  • Sebastian S Fuller

Abstract

Point-of-care tests (POCTs) to diagnose sexually transmitted infections (STIs) have potential to positively impact patient management and patient perceptions of clinical services. Yet there remains a disconnect between development of new technologies and their implementation into clinical care. With the advent of new STI POCTs arriving to the global market, guidance for their successful adoption and implementation into clinical services is urgently needed. We conducted qualitative in-depth interviews with professionals prior to and post-implementation of a Chlamydia trachomatis/Neisseria gonorrhoeae POCT into clinical services in England to define key stakeholder roles and explore the process of POCT integration. Participants self-identified themselves as key stakeholders in the STI POCT adoption and/or implementation processes. Data consisted of interview transcripts, which were analysed thematically using NVIVO 11. Six sexual health services were included in the study; three of which have implemented POCTs. We conducted 40 total interviews: 31 prior to POCT implementation and 9 follow-up post-implementation. Post-implementation data showed that implementation plans required little or no change during service evaluation. Lead clinicians and managers self-identified as key stakeholders for the decision to purchase, while nurses self-identified as “change champions” for implementation. Many identified senior clinical staff as those most likely to introduce and drive change. However, participants stressed the importance of engaging all clinical staff in implementation. While the accuracy of the POCT, its positive impact on patient management and the ease of its integration within existing pathways were considered essential, costs of purchasing and utilising the technology were identified as central to the decision to purchase. Our study shows that key decision-makers for adoption and implementation require STI POCTs to have laboratory-comparable accuracy and be affordable for purchase and ongoing use. Further, successful integration of POCTs into sexual health services relies on supportive interpersonal relationships between all levels of staff.

Suggested Citation

  • Agata Pacho & Emma M Harding-Esch & Emma G Heming De-Allie & Laura Phillips & Martina Furegato & S Tariq Sadiq & Sebastian S Fuller, 2022. "Facilitators and barriers for clinical implementation of a 30-minute point-of-care test for Neisseria gonorrhoeae and Chlamydia trachomatis into clinical care: A qualitative study within sexual health," PLOS ONE, Public Library of Science, vol. 17(3), pages 1-12, March.
  • Handle: RePEc:plo:pone00:0265173
    DOI: 10.1371/journal.pone.0265173
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0265173
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0265173&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0265173?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Goldenberg, Maya J., 2006. "On evidence and evidence-based medicine: Lessons from the philosophy of science," Social Science & Medicine, Elsevier, vol. 62(11), pages 2621-2632, June.
    2. Lambert, Helen, 2006. "Accounting for EBM: Notions of evidence in medicine," Social Science & Medicine, Elsevier, vol. 62(11), pages 2633-2645, June.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Perrotta, Manuela & Geampana, Alina, 2020. "The trouble with IVF and randomised control trials: Professional legitimation narratives on time-lapse imaging and evidence-informed care," Social Science & Medicine, Elsevier, vol. 258(C).
    2. Kris Hoang & Steven E. Salterio & Jim Sylph, 2018. "Barriers to Transferring Auditing Research to Standard Setters," Accounting Perspectives, John Wiley & Sons, vol. 17(3), pages 427-452, September.
    3. Ferlie, Ewan & Crilly, Tessa & Jashapara, Ashok & Peckham, Anna, 2012. "Knowledge mobilisation in healthcare: A critical review of health sector and generic management literature," Social Science & Medicine, Elsevier, vol. 74(8), pages 1297-1304.
    4. Broom, Alex & Adams, Jon & Tovey, Philip, 2009. "Evidence-based healthcare in practice: A study of clinician resistance, professional de-skilling, and inter-specialty differentiation in oncology," Social Science & Medicine, Elsevier, vol. 68(1), pages 192-200, January.
    5. Timmermans, Stefan & Almeling, Rene, 2009. "Objectification, standardization, and commodification in health care: A conceptual readjustment," Social Science & Medicine, Elsevier, vol. 69(1), pages 21-27, July.
    6. Blume, Stuart & Tump, Janneke, 2010. "Evidence and policymaking: The introduction of MMR vaccine in the Netherlands," Social Science & Medicine, Elsevier, vol. 71(6), pages 1049-1055, September.
    7. Kirmayer, Laurence J., 2012. "Cultural competence and evidence-based practice in mental health: Epistemic communities and the politics of pluralism," Social Science & Medicine, Elsevier, vol. 75(2), pages 249-256.
    8. Selma KOL & Mustafa METE, 2022. "Evaluation Of Patients' Attitudes To Traditional And Complementary Medicine A Case Of A Medical Center In Istanbul," Eurasian Eononometrics, Statistics and Emprical Economics Journal, Eurasian Academy Of Sciences, vol. 22(22), pages 34-52, September.
    9. Cavanagh, Alice & Shamsheri, Tahmina & Shen, Katrina & Gaber, Jessica & Liauw, Jessica & Vanstone, Meredith & Kouyoumdjian, Fiona, 2022. "Lived experiences of pregnancy and prison through a reproductive justice lens: A qualitative meta-synthesis," Social Science & Medicine, Elsevier, vol. 307(C).
    10. Scott, Clare & Walker, Jan & White, Peter & Lewith, George, 2011. "Forging convictions: The effects of active participation in a clinical trial," Social Science & Medicine, Elsevier, vol. 72(12), pages 2041-2048, June.
    11. Rubbio, Iacopo & Bruccoleri, Manfredi, 2023. "Unfolding the relationship between digital health and patient safety: The roles of absorptive capacity and healthcare resilience," Technological Forecasting and Social Change, Elsevier, vol. 195(C).
    12. Nigam, Amit, 2012. "Changing health care quality paradigms: The rise of clinical guidelines and quality measures in American medicine," Social Science & Medicine, Elsevier, vol. 75(11), pages 1933-1937.
    13. Hunt, Joanne Elizabeth, 2022. "Making space for disability studies within a structurally competent medical curriculum: Reflections on Long Covid," SocArXiv p9qyk, Center for Open Science.
    14. Moes, Floortje & Houwaart, Eddy & Delnoij, Diana & Horstman, Klasien, 2020. "Questions regarding ‘epistemic injustice’ in knowledge-intensive policymaking: Two examples from Dutch health insurance policy," Social Science & Medicine, Elsevier, vol. 245(C).
    15. Ackerman, Sara L. & Tebb, Kathleen & Stein, John C. & Frazee, Bradley W. & Hendey, Gregory W. & Schmidt, Laura A. & Gonzales, Ralph, 2012. "Benefit or burden? A sociotechnical analysis of diagnostic computer kiosks in four California hospital emergency departments," Social Science & Medicine, Elsevier, vol. 75(12), pages 2378-2385.
    16. Matthew Tieu & Michael Lawless & Sarah C. Hunter & Maria Alejandra Pinero de Plaza & Francis Darko & Alexandra Mudd & Lalit Yadav & Alison Kitson, 2023. "Wicked problems in a post-truth political economy: a dilemma for knowledge translation," Palgrave Communications, Palgrave Macmillan, vol. 10(1), pages 1-11, December.
    17. Reich, Adam, 2012. "Disciplined doctors: The electronic medical record and physicians' changing relationship to medical knowledge," Social Science & Medicine, Elsevier, vol. 74(7), pages 1021-1028.
    18. Sobo, Elisa J. & Bowman, Candice & Gifford, Allen L., 2008. "Behind the scenes in health care improvement: The complex structures and emergent strategies of Implementation Science," Social Science & Medicine, Elsevier, vol. 67(10), pages 1530-1540, November.
    19. Taipale, Jaakko & Hautamäki, Lotta, 2021. "Clinical practice guidelines in courts’ representation of medical evidence and testimony," Social Science & Medicine, Elsevier, vol. 275(C).
    20. Silje Gustafsson & Irene Vikman & Stefan Sävenstedt & Jesper Martinsson, 2015. "Perceptions of needs related to the practice of self‐care for minor illness," Journal of Clinical Nursing, John Wiley & Sons, vol. 24(21-22), pages 3255-3265, November.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0265173. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.