Improving rural outcomes one test at a time

Dr Brooke Spaeth (centre) with the NT Point-of-Care Testing Program team. Photo: Annika Dean

A spur-of-the-moment decision to undertake an elective in Point-of-care testing (POCT) during her Medical Science studies at Flinders University led Dr Brooke Spaeth (BMedSc ’09, BSc(Hons) ’10, PhD(Med) ’18) to her current role as Project Chief Investigator of a study trialling a newly available POCT device which provides full blood examination (FBE) results in less than 10 minutes.

“At the very first POC lecture, I was hooked,” says Dr Spaeth.

“The lecturer, Professor Mark Shephard, described the scope and applications for POC testing as ‘unlimited’, and I immediately thought of my experience of blood testing growing up in a rural town, and how it could have been dramatically improved with POCT.”

“I was lucky enough to be the first student to approach Professor Shephard to do an honours project which has ultimately led to my rewarding career.”

So why is POCT such a game-changer for communities nationwide? Rather than waiting sometimes many days, pathology results are presented to patients during the initial consultation, meaning decisions regarding patient care can be made and communicated quickly, significantly improving patient outcomes and safety.

In rural and remote locations, the benefits of POCT are amplified due to the vast distances to central laboratory services, which creates barriers to accessing traditional pathology testing. “The overarching aim of the trial is to improve outcomes, particularly for sepsis, and to reduce health costs for rural and remote healthcare while ensuring equitable access to fundamental blood tests for Aboriginal and Torres Strait Islander communities,” says Dr Spaeth.

“The study also aims to determine the broader clinical benefits of having immediate full blood examination results available, which may include improvements in monitoring kidney disease, respiratory infections and anaemia.”

Despite being the most requested laboratory pathology test in Australia, FBE tests are not reliably accessible in rural and remote communities, leading to delayed diagnosis and treatment.

Dr Spaeth, who is also a Research Fellow and former Coordinator of Flinders University’s Northern Territory POC Testing Program, says the availability of the FBE test is especially important for time-critical clinical conditions, where early and accurate diagnosis can significantly improve patient outcomes and has the potential to save lives.

The study, titled ‘Equitable access to Full Blood Examination (FBE) testing at the point-of-care in remote primary health’, aims to reduce time to treatment with antibiotics for patients who are suspected of sepsis in remote primary health care centres, thereby reducing sepsis-related morbidity and mortality.

“Our main aim is to understand if using the test reduces the time to treatment for patients who are diagnosed with sepsis, while also looking to see if access to the test reduces the incidence of both septic shock and the need for medical evacuations for suspected sepsis, as well as generating economic benefits that justify the costs of establishing the program” says Dr Spaeth.

“The scope and potential of Point-of-care testing is limitless. Scalability is key, and so we will ensure any improvements we are able to uncover are translatable to other rural and remote communities, while ensuring cultural safety and delivering improved health equity for Aboriginal and Torres Strait Islander communities.”

The study has been awarded almost $3M by the Medical Research Future Fund Primary Health Care Research stream, and has now received ethical approval with the first health centres to commence using the FBE POC device in early 2024.

Project partners are Sepsis Australia (George Institute for Global Health), Northern Territory Health, National Aboriginal Community Controlled Health Organisation, Aboriginal Medical Services Alliance Northern Territory, and the Royal College of Pathologists of Australasia.

Learn more about POC testing at Flinders.edu.au/poc-testing

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2023 MPH Alumni Magazine College of Medicine and Public Health Health Medicine

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