GPs' acceptability and feasibility for using point-of-care tests for cancer in primary care: a qualitative interview study.

Abstract

Background: Primary care is the first point of contact for patients with symptoms suspicious of cancer. The availability of reliable, rapid diagnostic cancer tests, at the 'point of care', have the potential to expedite diagnosis, and support timely management of patients.

Aim: To explore the acceptability and feasibility of using Point of Care tests (POCTs) for detecting cancer among UK general practitioners (GPs), including barriers and facilitators to uptake.

Design & setting: A qualitative semi-structured interview study with thirty-two UK GPs.

Method: Online and telephone interviews guided by the Theoretical Framework of Acceptability were conducted. The data was analysed inductively using framework analysis.

Results: GPs found POCTs acceptable if they were accurate, well-designed, and supported by robust evidence. Funding for tests and implementation resources were crucial, with an expectation of remuneration for their time. GPs believed POCTs could improve patient triage, reduce secondary care referrals, and facilitate clearer communication of referral decisions with patients. Concerns included potential workload increase, and over-testing in patients. Facilitators for uptake included recommendations in guidelines, peer acceptance, and comprehensive training. However, low awareness of POCTs among GPs and slow innovation adoption within the NHS were significant barriers.

Conclusion: Most GPs welcome the use of POCTs for cancer detection in primary care, however, this will require substantial system-level changes. We highlight the relevant considerations and challenges that need to be addressed prior to uptake. This study also calls attention to wider innovation implementation issues that should be considered by GPs, test developers, policy makers and stakeholders.