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C reactive protein test © Shutterstock

The significant demand for inflammatory marker laboratory tests in general practice highlights an untapped opportunity for point-of-care diagnostics in the community, suggests research from the NIHR Community Healthcare MedTech and In Vitro Diagnostics Co-operative.

Reported in the Journal of Clinical Pathology, the study finds that GP practices typically request 36 CRP tests and 72 neutrophil count tests per week.

From the Universities of Oxford, Birmingham and KU Leuven in Belgium, the research team analysed data more than 1.14 million C-Reactive Protein (CRP) and neutrophil count test requests in over 435,000 patients from 69 general practices in Oxfordshire between 2014-16.

This corresponds roughly to one CRP test requested per five people per year and one neutrophil test requested per three people per year. More than 70% of those initially tested would require another test in a three-year period.

CRP and neutrophil count are important biomarkers of inflammation used by general practitioners. CRP levels in the blood typically rise rapidly in response to infection and inflammatory conditions. A raised neutrophil count indicates abnormal inflammation which may result from acute bacterial infection, while a low neutrophil count can be a warning that a patient is at higher risk of serious bacterial infection, which can be a complication of treatments such as chemotherapy.

GPs often have to wait up to 24 hours to receive test results from central laboratories, despite the availability of existing point-of-care equivalents.

Lead author Dr José Ordóñez-Mena, Medical Statistician in Oxford University’s Nuffield Department of Primary Care Health Sciences, commented:

Inflammatory marker laboratory tests are requested frequently in the community, particularly in combination, with many patients needing repeat tests. We also find that CRP test requests are becoming increasingly common in older patients. Given that these tests can now be provided by point-of-care technologies, there is scope for this testing to start moving into the community, carried out by general practitioners for results within minutes, rather than being performed by central laboratories.

Read more:

José M Ordóñez-Mena, Thomas R Fanshawe, David McCartney, Brian Shine, Ann Van den Bruel, Daniel Lasserson, Gail Hayward.
Journal of Clinical Pathology 2019