CRP POCT in nursing homes; UPCARE study completed

Star-shl has more than 20 nursing home organisations, with more than 150 locations, as customers. The demand for cooperation relating to POCT is growing. This is partly due to the introduction of the CRP test in the new Guidelines for the Management of Lower Respiratory Tract Infections in Elderly Care (Verenso). Although the added value of CRP for the diagnosis of pneumonia is clear, there is still no evidence that CRP as a point-of-care test can also help to prevent the unnecessary use of antibiotics in patients staying in a nursing home.

We investigated this in 10 nursing home organisations in the Netherlands. The study is called “Using Point-of-Care C-reactive Protein to Guide Antibiotic Prescribing for Respiratory Tract Infections in Elderly Nursing Home Residents” (UPCARE) and is led by the VUMC.

The National Institute for Public Health and the Environment (RIVM), University Medical Centre Utrecht (UMCU), University of Maastricht (UM) and Saltro are the other partners in this study. The ZonMw Antibiotics Resistance Committee has previously assessed this study as ‘extremely relevant’.

Using a randomised design, we studied whether the use of CRP POCT in nursing homes leads to reductions in unnecessary antibiotic use compared to nursing homes that do not have CRP POCT at their disposal. In addition, among other things, attention is paid to cost effectiveness and factors that complicate or speed up implementation. Rogier Hopstaken is a member of the project group.

In six nursing homes, CRP POCT was introduced following personal training and instruction (Quikread go, Aidian). Five nursing homes were part of the control group. The study included 241 patients with a lower respiratory tract infection: 162 in the intervention group and 79 in the control group. Most patients were staying on the somatic and psychogeriatric wards.

The study ran smoothly and was completed shortly before the COVID-19 outbreak. It is still too early to share the main results. We will let you know as soon as possible whether CRP POCT also helps vulnerable elderly people in nursing homes to treat patients more effectively and with fewer unnecessary antibiotics, and whether the use of CRP POCT is cost-effective and found to be suitable for implementation in nursing home care.