Optimizing Point-of-Care Testing for Diabetes Management in a Rural Australian General Practice

Since 2004, the Flinders University International Centre for Point-of-Care Testing has assisted the Mallee Track Health & Community Service with a point-of-care testing (POCT) service for diabetes management in rural Australia. The POCT devices originally implemented were the DCA 2000 (hemoglobin A1c) and the Cholestech (glucose, lipids). In recent years, new options for POCT have become available, including the DCAVantage (hemoglobin A1c), the StatStrip (glucose), and the Piccolo (glucose, lipids). The analytical performance of the POCT devices was evaluated using a patient comparison study (n = 103) to measure accuracy and using on-site quality control testing to measure between-day imprecision. Stakeholder satisfaction was assessed using questionnaires for patients with diabetes (n = 60) and focus interviews with the POCT operator and general practitioner. The DCAVantage and Piccolo exhibited sound analytical performance. A statistically significant improvement in satisfaction with the new devices was reported by the patients (Fisher exact probability, P < 0.05). All stakeholders showed high levels of satisfaction with POCT in terms of convenience, acceptability, and confidence in test results. This study supports the effective use of POCTin rural general practice settings for diabetes management.