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HTA of C-reactive protein point-of-care testing to guide antibiotic prescribing

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Background

In February 2018, the Health Information and Quality Authority (HIQA) commenced work on a health technology assessment (HTA) in relation to C-reactive protein point-of-care testing (CRP POCT). HIQA agreed to undertake the HTA following a formal request from the Lead of the Primary Care Clinical Programme in the Health Service Executive (HSE). The aim of the HTA was to establish the clinical and economic impact of providing point-of-care testing to inform antibiotic prescribing for patients presenting with symptoms of acute respiratory tract infections (RTIs) in primary care. This request was endorsed by the Department of Health and was included in the 2018 HIQA HTA work plan.

Antimicrobial resistance occurs when bacteria adapt in response to the use of medicines.

When bacteria become resistant to antibiotics, infections become more difficult to manage and treat. Antimicrobial resistance is a significant threat to public health, and widely acknowledged to be associated with the excessive and inappropriate consumption of antibiotics. Most antibiotics are prescribed in primary care settings, frequently to treat respiratory tract infections, which account for approximately one quarter of primary care attendances.



The objective of C-reactive protein point-of-care testing (CRP POCT) is to assist the clinician in ruling out serious bacterial infection, thereby supporting a decision not to prescribe an antibiotic to those who are unlikely to benefit from treatment. HIQA’s health technology assessment reviews the clinical and cost-effectiveness of CRP POCT. The assessment will inform a decision as to whether CRP POCT should be used to support antibiotic prescribing in primary care for patients presenting with symptoms of acute respiratory tract infection. The assessment also considers the organisational implications associated with introducing CRP POCT in primary care.



Work on the assessment was undertaken by an Evaluation Team from the HTA Directorate in HIQA. A multidisciplinary Expert Advisory Group was convened to advise HIQA during the course of the assessment. HIQA would like to thank its Evaluation Team, the members of the Expert Advisory Group and all who contributed to the preparation of this report.