Your browser doesn't support javascript.
Enhanced lateral flow testing strategies in care homes are associated with poor adherence and were insufficient to prevent COVID-19 outbreaks: results from a mixed methods implementation study.
Tulloch, John S P; Micocci, Massimo; Buckle, Peter; Lawrenson, Karen; Kierkegaard, Patrick; McLister, Anna; Gordon, Adam L; García-Fiñana, Marta; Peddie, Steve; Ashton, Matthew; Buchan, Iain; Parvulescu, Paula.
  • Tulloch JSP; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool CH64 7TE, UK.
  • Micocci M; NIHR London In Vitro Diagnostics Co-operative, Department of Surgery and Cancer, Imperial College London, London W2 1NY, UK.
  • Buckle P; NIHR London In Vitro Diagnostics Co-operative, Department of Surgery and Cancer, Imperial College London, London W2 1NY, UK.
  • Lawrenson K; Public Health Department, Liverpool City Council, Liverpool L3 1DS, UK.
  • Kierkegaard P; NIHR London In Vitro Diagnostics Co-operative, Department of Surgery and Cancer, Imperial College London, London W2 1NY, UK.
  • McLister A; CRUK Convergence Science Centre, Institute for Cancer Research & Imperial College London, London SW7 2AZ, UK.
  • Gordon AL; NIHR London In Vitro Diagnostics Co-operative, Department of Surgery and Cancer, Imperial College London, London W2 1NY, UK.
  • García-Fiñana M; Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Nottingham, UK.
  • Peddie S; NIHR Applied Research Collaboration East Midlands (ARC-EM), Nottingham, UK.
  • Ashton M; Institute of Population Health, University of Liverpool, Liverpool, UK.
  • Buchan I; Adults Social Care Department, Liverpool City Council, Liverpool L3 1DS, UK.
  • Parvulescu P; Public Health Department, Liverpool City Council, Liverpool L3 1DS, UK.
Age Ageing ; 50(6): 1868-1875, 2021 11 10.
Article in English | MEDLINE | ID: covidwho-1316792
ABSTRACT

INTRODUCTION:

Care homes have been severely affected by the SARS-CoV-2 pandemic. Rapid antigen testing could identify most SARS-CoV-2 infected staff and visitors before they enter homes. We explored implementation of staff and visitor testing protocols using lateral flow devices (LFDs).

METHODS:

An evaluation of a SARS-CoV-2 LFD-based testing protocol in 11 care homes in Liverpool, UK, including staff and visitor testing, plus a qualitative exploratory study in nine of these homes. The proportion of pilot homes with outbreaks, and outbreak size, were compared to non-pilot homes in Liverpool. Adherence to testing protocols was evaluated. Fifteen staff were interviewed, and transcript data were thematically coded using an iterative analysis to identify and categorize factors influencing testing implementation.

RESULTS:

In total, 1,638 LFD rapid tests were performed on 407 staff. Protocol adherence was poor with 8.6% of staff achieving >75% protocol adherence, and 25.3% achieving $\ge$50%. Six care homes had outbreaks during the study. Compared to non-pilot care homes, there was no evidence of significant difference in the proportion of homes with outbreaks, or the size of outbreaks. Qualitative data showed difficulty implementing testing strategies due to excessive work burden. Factors influencing adherence related to test integration and procedural factors, socio-economic factors, cognitive overload and the emotional value of testing.

CONCLUSION:

Implementation of staff and visitor care home LFD testing protocols was poorly adhered to and consequently did not reduce the number or scale of COVID-19 outbreaks. More focus is needed on the contextual and behavioural factors that influence protocol adherence.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Prognostic study / Qualitative research / Risk factors Limits: Humans Language: English Journal: Age Ageing Year: 2021 Document Type: Article Affiliation country: Ageing

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Prognostic study / Qualitative research / Risk factors Limits: Humans Language: English Journal: Age Ageing Year: 2021 Document Type: Article Affiliation country: Ageing