Implementation of multiparameter point-of-care testing devices for non-communicable diseases at primary healthcare level in Peru

Background: Point-of-care testing (POCT) devices are a potential solution to improving access to faster and more accurate diagnosis of non-communicable diseases (NCDs), particularly in resource-limited settings. However, evidence about their implementation in low- and middle- income countries is limited. Aim: To determine the potential utility of a co-created strategy for implementing multiparameter POCT devices to improve care for three NCDs at public primary healthcare centres in urban and rural areas in Tumbes, Peru. Methods: This quasi-experimental cluster trial with a concurrent control was conducted in Tumbes, Peru. This study compared the current standard of care (conventional testing) to POCT in the screening and monitoring of certain NCDs (type 2 diabetes, kidney disease, and hypercholesterolemia) among patients at the primary healthcare level. The diagnosis was based on Peruvian clinical practice guidelines for NCDs. The intervention consisted of training for health professionals, implementing a POCT device in the laboratory for three months, advertising the population about the availability of this new device, and three months of follow-up care for participants. Relative risk (RR) was estimated. Results: 1,234 participants were recruited in eight facilities. 37.8% of participants received a new diagnosis. Using POCT alone significantly increased the diagnosis of new diabetes cases (adjusted relative risk [aRR]: 1.84) and high cholesterol detection (aRR: 1.24) compared to conventional testing. The combination of POCT plus conventional testing showed even greater increases in diabetes (aRR: 2.42) and high cholesterol diagnoses (aRR: 1.56) compared to control sites. Conclusions: The use of POCT significantly increased the diagnosis of diabetes and high cholesterol compared to conventional laboratory testing. This suggests that POCT may be an effective tool for increased early detection of NCDs.