Imperial College London
Alternate

Professor Michael Loebinger

Faculty of Medicine, National Heart & Lung Institute

Professor of Practice (Respiratory Medicine)
 
 
 
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Contact

 

+44 (0)20 7351 8337m.loebinger

 
 
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Location

 

Fulham RoadRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Nwankwo:2021:10.1136/bmjoq-2020-001192,
author = {Nwankwo, L and McLaren, K and Donovan, J and Ni, Z and Vidal-Diaz, A and Loebinger, M and Morrisey, A and Igra, A and Shah, A},
doi = {10.1136/bmjoq-2020-001192},
journal = {BMJ Open Quality},
pages = {1--11},
title = {Utilisation of remote capillary blood testing in an outpatient clinic setting to improve shared decision making and patient and clinician experience: a validation and pilot study},
url = {http://dx.doi.org/10.1136/bmjoq-2020-001192},
volume = {10},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background In a tertiary respiratory centre, large cohorts of patients are managed in an outpatient setting and require blood tests to monitor disease activity and organ toxicity. This requires either visits to tertiary centres for phlebotomy and physician review or utilisation of primary care services.Objectives This study aims to validate remote capillary blood testing in an outpatient setting and analyse impact on clinical pathways.Methods A single-centre prospective cross-sectional validation and parallel observational study was performed. Remote finger prick capillary blood testing was validated compared with local standard venesection using comparative statistical analysis: paired t-test, correlation and Bland-Altman. Capillary was considered interchangeable with venous samples if all three criteria were met: non-significant paired t-test (ie, p>0.05), Pearson’s correlation coefficient (r)>0.8% and 95% of tests within 10% difference through Bland-Altman (limits of agreement). In parallel, current clinical pathways including phlebotomy practice were analysed over 4 weeks to review test predictability. A subsequent pilot cohort study analysed potential impact of remote capillary blood sampling on shared decision making. A final implementation phase ensued to embed the service into clinical pathways within the institution.Results 117 paired capillary and venous blood samples were prospectively analysed. Interchangeability with venous blood was seen with glycated haemoglobin (%), total protein and C reactive protein. Further tests, although not interchangeable, are likely useful to enable longitudinal remote monitoring (eg, liver function and total IgE). 65% of outpatient clinic blood tests were predictable with 16% of patients requiring further follow-up. Patient and clinician-reported improvement in shared decision making given contemporaneous blood test results was observed.Conclusions Remote capillary blood sampling can be used accurately fo
AU  - Nwankwo,L
AU  - McLaren,K
AU  - Donovan,J
AU  - Ni,Z
AU  - Vidal-Diaz,A
AU  - Loebinger,M
AU  - Morrisey,A
AU  - Igra,A
AU  - Shah,A
DO  - 10.1136/bmjoq-2020-001192
EP  - 11
PY  - 2021///
SN  - 2399-6641
SP  - 1
TI  - Utilisation of remote capillary blood testing in an outpatient clinic setting to improve shared decision making and patient and clinician experience: a validation and pilot study
T2  - BMJ Open Quality
UR  - http://dx.doi.org/10.1136/bmjoq-2020-001192
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000687862900001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://bmjopenquality.bmj.com/content/10/3/e001192
UR  - http://hdl.handle.net/10044/1/91710
VL  - 10
ER  -
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