Patient and physician views of self-testing: blood glucose monitoring

Abstract

Medical laboratories deliver an invaluable healthcare service by providing laboratory results to aid in the diagnosis and monitoring of disease states. Point-of-care testing (POCT), a sub-sector of medical laboratory services, is completed at the patient’s bedside with the goal of providing clinical laboratory results in a very short time frame to assist caregivers in clinical decision making (Ehrmeyer & Laessig, 2007). The technology within this sector of laboratory sciences continues to grow rapidly, making Point-of-Care (POC) tests more accessible for use in a variety of settings, essentially decentralizing laboratory testing. This represents an important shift in healthcare culture as it provides healthcare practitioners and patients alike, the opportunity to perform an ever-growing number of laboratory tests, anywhere and at any time. Through the use of semi-structured interview questions, this qualitative research project utilized a case study informed methodology to understand the role of patient autonomy in self-testing (ST) and the function of accountability as it relates to POCT, when testing occurs in an unregulated environment. Findings suggest that ST and self-care behaviours in diabetes that are autonomously initiated result in positive outcomes, as patients are more likely to be active participants in their own healthcare. The principle of patient autonomy was highlighted in the research by the need to build strong patient/physician relationships in order to facilitate dialogue that promotes informed decision-making, an important aspect of patient care. Patients also felt that participating in ST provided them with a greater sense of control over their health, and that an increased frequency of ST could be seen only in a positive manner, regardless of which self-test was being performed. Conversely, the cost and the possibility of encountering difficulties in the interpretation and troubleshooting of self-test results were seen as negative aspects of ST. Through this research endeavour, the necessity for greater measures of accountability were also made evident, as patients and physicians discussed how self-testing could impact patient care. Short-term and long-term goals are provided as recommendations to strengthen accountability in POCT within unregulated environments.