@article {ChamiBJGPO.2022.0005, author = {Jason Chami and Susannah Fleming and Clare J Taylor and Clare R Bankhead and Tim James and Brian Shine and Julie McLellan and FD Richard Hobbs and Rafael Perera}, title = {Point-of-care NT-proBNP monitoring for heart failure: observational feasibility study in primary care}, elocation-id = {BJGPO.2022.0005}, year = {2022}, doi = {10.3399/BJGPO.2022.0005}, publisher = {Royal College of General Practitioners}, abstract = {Background Around one million individuals in the UK have heart failure (HF), a chronic disease that causes significant morbidity and mortality. N-terminal pro-B-type natriuretic peptide (NT-proBNP) monitoring could help improve the care of patients with HF in the community.Aim The aim of this study is to provide evidence to support the routine use of point-of-care (POC) NT-proBNP monitoring in primary care.Design \& setting In this observational cohort study, the Roche Cobas h 232 POC device was used to measure NT-proBNP in 27 patients with HF at 0, 6, and 12 months, with a subset reanalysed in the laboratory for comparison.Method Data were analysed for within-person and between-person variability and concordance with laboratory readings using Passing{\textendash}Bablok regression. GPs reported whether POC results impacted clinical decisionmaking, and patients indicated their willingness to participate in long-term cohort studies using the Likert acceptability scale.Results Within-person variability in POC NT-proBNP over 12 months was 881 pg/mL (95\% confidence interval [CI] = 380 to 1382 pg/mL). Between-person variability was 1972 pg/mL (95\% CI = 1,525 to 2791 pg/mL). Passing{\textendash}Bablok regression showed no significant systematic difference between POC and laboratory measurements. Patients indicated a high level of acceptability, and GP decisionmaking was affected for at least one visit in a third of patients.Conclusion Within-person variability in POC NT-proBNP is around half of between-person variability, so detecting changes could be of use in HF management. High patient acceptability and impact on clinical decisionmaking warrant further investigation in a larger long-term cohort study.}, URL = {https://bjgpopen.org/content/early/2022/07/11/BJGPO.2022.0005}, eprint = {https://bjgpopen.org/content/early/2022/07/11/BJGPO.2022.0005.full.pdf}, journal = {BJGP Open} }