Clinical perspectives on point-of-care UTI testing

Antibiotic resistance is a significant threat to public health and refining the clinical use of antimicrobials is a priority. Better access to rapid diagnostic technologies in the management of urinary tract infections is key. Brookes-Howell and colleagues conducted telephone interviews with primary care clinicians in Wales, England, Spain, and the Netherlands to explore clinicians’ experiences of Flexicult point-of-care testing. Clinicians expressed increased confidence in diagnosing UTIs accurately and were positive about point-of-care testing. However, test results still took 24 hours and uptake into routine care could be enhanced in a number of areas including training for interpretation of ‘grey area’ results.

Coronary heart disease preceding type 2 diabetes

Coronary heart disease and diabetes are linked, but we usually think of heart disease as a complication. In the ROSA 4 study in Norway, Gjelsvik and colleagues highlight how heart disease precedes a diabetes diagnosis in nearly half of patients, sometimes by several years. South Asians had a significantly higher prevalence of coronary heart disease and a younger age of onset too. They noted that in coronary heart disease and stroke, lipid lowering medications were not prescribed in 23% and 33% of people respectively. These suggest potential for improvement but qualitative investigation may be needed to clarify underlying reasons. 

Pain management in aged care facilities

Pain is a common problem in people who live in aged care facilities, with more than 80% experiencing persistent pain. Veal and colleagues analysed the medical records of several facilities in Tasmania and found that over 25% of residents had at least one episode of pain in the week before. Overall, pain management was good, however, nearly 1 in 5 residents had pain two or more times per week and remained on ‘as required’ analgesia which may be sub-optimal. A lower rate of documented pain conditions was found in people with dementia and may reflect underrecognition in these residents.