The UPCARE cluster randomised controlled trial on the effect of CRP POCT in nursing homes (VUmc, UMCU, RIVM, Star-shl) showed that a 30% reduction in unnecessary antibiotic prescriptions could be achieved. The study was published in the renowned The British Medical Journal.
The added value that CRP provides in diagnosing pneumonia is well established. We have previously also been able to demonstrate that implementing CRP POCT in general practices leads to fewer unnecessary antibiotic prescriptions. However, there was no evidence thus far that CRP POCT could also safely reduce antibiotic prescribing among the most vulnerable group of patients: nursing home residents.
We have now been able to demonstrate this in a randomised trial of 241 sick, coughing patients in 11 nursing home organisations: the UPCARE study. Implementing CRP POCT made it possible to achieve a 30% reduction in unnecessary antibiotic prescriptions.
The CRP POCT method has been included in the Verenso Guidelines for Low Respiratory Tract Infections, Implementation in Nursing Home Care. We have now also developed a national implementation roadmap, based in part on the process evaluation that we also published this year. Principal investigator Tjarda Boere successfully defended her PhD dissertation on 'C-reactive protein testing at the point-of-care in nursing homes: Towards more rational antibiotic prescribing for suspected lower respiratory tract infections' on 13 December 2021.
In the meantime, Star-shl has cautiously started a quality-assured roll-out of our CRP POCT service to the first nursing homes in the Netherlands.
Boere, T. M. (2021). C-reactive protein testing at the point-of-care in nursing homes: Towards more rational antibiotic prescribing for suspected lower respiratory tract infections. GVO, drukkers & vormgevers B.V.
Boere TM, van Buul LW, Hopstaken RM, van Tulder MW, Twisk JWMR, Verheij TJM, Hertogh CMPM. Effect van CRP point-of-care testing op het voorschrijven van antibiotica voor verpleeghuisbewoners met mogelijke lage luchtweginfecties. Ned Tijdschr Geneeskd. (accepted)
Boere TM, van Buul LW, Hopstaken RM, van Tulder MW, Twisk JWMR, Verheij TJM, Hertogh CMPM. Effect of C reactive protein point-of-care testing on antibiotic prescribing for lower respiratory tract infections in nursing home residents: cluster randomised controlled trial. Brit Med J. 2021 Sep 21;374:n2198. doi: 10.1136/bmj.n2198. PMID: 34548288.
Boere TM, Hopstaken RM, van Tulder MW, Schellevis FG, Verheij TJM, Hertogh CMPM, van Buul LW. Implementation and Use of Point-of-Care C-Reactive Protein Testing in Nursing Homes. J Am Med Dir Assoc. 2021 Oct 7:S1525-8610(21)00830-6. doi: 10.1016/j.jamda.2021.09.010.
Minder antibioticagebruik in verpleeghuizen door CRP-sneltest
Medisch Contact 28 sept 2021; Nieuwsbericht