Perspectives of physicians and medical assistants on the implementation of NAAT-based point-of-care testing for SARS-CoV-2 in primary care in Germany.

INTRODUCTION: Given their high diagnostic accuracy and fast turnaround time, rapid SARS-CoV-2 tests based on nucleic acid amplification technologies (NAAT) have great potential to expand access to testing and decrease delays in diagnosis of COVID-19. OBJECTIVES: The aim of this study was to investigate feasibility, acceptance, organizational consequences and other implementation aspects of the use of a NAAT-based SARS-CoV-2 rapid test (ID NOW™ COVID-19, Abbott Diagnostics) for symptomatic primary care patients with a suspected SARS-CoV-2 infection. METHODS: Cross-sectional survey among primary care physicians and medical assistants from Thuringia (Germany) during the third wave of the COVID-19 pandemic in March and April 2021. The health care providers surveyed had previously used the NAAT-based SARS-CoV-2 rapid test as part of a pilot study. RESULTS: Eleven physicians (ten general practitioners and one paediatrician) and 22 medical assistants from Thuringia (Germany) participated in the written survey. Four physicians were additionally interviewed. The majority of the surveyed health care providers rated user-friendliness, integration into practice routine, impact on communication with patients and technical reliability of the NAAT-based SARS-CoV-2 rapid test as (very) positive. Greater workload and the costs for measuring devices were identified as disadvantages compared to PCR laboratory tests. Four out of ten physicians rated the lower sample turnover as unfavourable. CONCLUSION: Our survey shows that NAAT-based point-of-care SARS-CoV-2 testing gained widespread acceptance among physicians and medical assistants, positively influences workflows, can improve patient communication and could therefore be successfully implemented into routine primary care.

Shared decision-making in Malaysia: Legislation, patient involvement, implementation and the impact of COVID-19.

Shared decision making (SDM) activities in Malaysia began around 2010. The rise in the numbers of patients with chronic disease in Malaysia underscores a growing need for doctors to practice patient-centred care and SDM as more Malaysians come into regular contact with health decision-making scenarios. Recent guidelines for medical professionalism have emphasized that options and risks be discussed in consultations, especially for procedures with risk of adverse outcomes. Although SDM is not legally required, principles of SDM are applied in legal judgements on informed consent. Research on SDM has grown to include the adoption of patient and public involvement in research, an increased emphasis on incorporating local cultural values in SDM, and implementation of SDM in Malaysia's health system and organizational culture. While COVID-19 hindered the progress of SDM research, one positive development was that vaccination choices heightened public consciousness about personal decisional autonomy and the need to discuss pros and cons with doctors before making a medical decision.