‘No, it is a virus, your body will fight it.’ The value of diagnostic testing for managing respiratory viruses in primary care: an observational study from a post-COVID pilot programme

Abstract

Introduction International studies suggest that advancing diagnostic technologies have the potential to reduce uncertainty and improve management of acute respiratory infections. Aim This study aimed to observe the impact that laboratory-based polymerase chain reaction testing for respiratory viruses, alongside a COVID-19 rapid antigen test, had on patient management during a pandemic. Observations may enhance knowledge about the utility of respiratory virus testing in primary care. Method The electronic medical records of patients tested at one urban general practice in New Zealand were examined 90 days before and after respiratory virus testing to record and analyse data on test results, patient characteristics, antibiotic prescribing, presentations, and follow-up communications. Results Among 298 presentations reviewed, 53% tested positive via polymerase chain reaction test. Antibiotics were prescribed for 37% of all presentations. Patients who tested positive for a respiratory virus were more likely to receive an antibiotic prescription than those who tested negative, both before and after test results. Notes showed texts and emails being used effectively to convey test results although some lacked evidence of test result communication. No impact on presentation patterns was identified. Discussion Test results were used for effective follow-up with some patients, but there were also gaps in communication of results and variation in prescribing patterns following receipt of test results. Test-based limitations as well as broader environmental, clinical, and psychological factors are hypothesised as influencing test use. Advancing point-of-care technologies which offer faster result availability may address some, but not all of these issues.