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Evaluating point-of-care testing for glycosylated haemoglobin in public sector primary care facilities in the Western Cape, South Africa

dc.contributor.authorMash, R.en_ZA
dc.contributor.authorUgoagwu, A.en_ZA
dc.contributor.authorVos, C.en_ZA
dc.contributor.authorRensburg, M.en_ZA
dc.contributor.authorErasmus, R.en_ZA
dc.date.accessioned2017-10-17T06:40:05Z
dc.date.available2017-10-17T06:40:05Z
dc.date.issued2016
dc.identifier.citationMash, R., et al. 2016. Evaluating point-of-care testing for glycosylated haemoglobin in public sector primary care facilities in the Western Cape, South Africa. South African Medical Journal, 106(12):1236-1240, doi:10.7196/SAMJ.2017.v106i12.10728
dc.identifier.issn2078-5135 (online)
dc.identifier.issn0256-9574 (print)
dc.identifier.otherdoi:10.7196/SAMJ.2017.v106i12.10728
dc.identifier.urihttp://hdl.handle.net/10019.1/102342
dc.descriptionCITATION: Mash, R., et al. 2016. Evaluating point-of-care testing for glycosylated haemoglobin in public sector primary care facilities in the Western Cape, South Africa. South African Medical Journal, 106(12):1236-1240, doi:10.7196/SAMJ.2017.v106i12.10728.
dc.descriptionThe original publication is available at http://www.samj.org.za
dc.description.abstractBackground. Diabetes mellitus contributes significantly to the burden of disease in South Africa (SA). Monitoring of glycaemic control with glycosylated haemoglobin (HbA1c) is recommended, even though current laboratory-based testing does not support immediate clinical decision-making. Objectives. To evaluate the costs and consequences for quality of care by introducing point-of-care (POC) testing for HbA1c for patients with type 2 diabetes at community health centres in Cape Town, SA. Methods. A quasi-experimental study was conducted at two control and two intervention sites in the same sub-district. The DCA Vantage Analyzer (Siemens, Germany) for POC testing was introduced at the intervention sites for 12 months. Patients were randomly selected from the diabetes register at the intervention (n=300) and control (n=300) sites, respectively, and data were collected from patient records at baseline and 12 months. Focus group interviews were performed at the intervention sites. Technical quality and cost implications were evaluated. Results. POC testing was feasible, easy to integrate into the organisation of care, resulted in more immediate feedback to patients (p<0.001) and patients appeared more satisfied. POC testing did not improve test coverage, treatment intensification, counselling or glycaemic control. There was an incremental cost of ZAR2 110 per 100 tests. Compliance with quality control was poor, although control tests showed good reliability. Conclusion. This study does not support the introduction of POC testing for HbA1c in public sector primary care practice in the current context. POC testing should be evaluated further in combination with interventions to overcome clinical inertia and strengthen primary healthcare.en_ZA
dc.description.urihttp://www.samj.org.za/index.php/samj/article/view/11590
dc.format.extent5 pages ; illustrations
dc.language.isoen_ZAen_ZA
dc.publisherHealth & Medical Publishing Group
dc.subjectPoint-of-care testing -- Western Cape (South Africa)en_ZA
dc.subjectGlycosylated haemoglobin -- Testing -- Western Cape (South Africa)en_ZA
dc.subjectPrimary care (Medicine) -- Western Cape (South Africa)en_ZA
dc.subjectHealth facilities -- Western Cape (South Africa)en_ZA
dc.titleEvaluating point-of-care testing for glycosylated haemoglobin in public sector primary care facilities in the Western Cape, South Africaen_ZA
dc.typeArticleen_ZA
dc.description.versionPublisher's version
dc.rights.holderSouth African Medical Journal


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