PT - JOURNAL ARTICLE AU - Timothy Jones AU - Rita Patel AU - Martha M C Elwenspoek AU - Jessica C Watson AU - Ed Mann AU - Katharine Alsop AU - Penny F Whiting TI - Variation in laboratory testing for patients with long-term conditions: a longitudinal cohort study in UK primary care AID - 10.3399/BJGPO.2022.0139 DP - 2023 Mar 01 TA - BJGP Open PG - BJGPO.2022.0139 VI - 7 IP - 1 4099 - http://bjgpopen.org/content/7/1/BJGPO.2022.0139.short 4100 - http://bjgpopen.org/content/7/1/BJGPO.2022.0139.full SO - BJGP Open2023 Mar 01; 7 AB - Background Use of laboratory testing has increased in the UK over the past few decades, with considerable geographical variation.Aim To evaluate what laboratory tests are used to monitor people with hypertension, type 2 (T2) diabetes, or chronic kidney disease (CKD) and assess variation in test use in UK primary care.Design & setting Longitudinal cohort study of people registered with UK general practices between June 2013 and May 2018 and previously diagnosed with hypertension, T2 diabetes, or CKD.Method Clinical Practice Research Datalink (CPRD) primary care data linked to ethnic group and deprivation was used to examine testing rates over time, by GP practice, age, sex, ethnic group, and socioeconomic deprivation, with age–sex standardisation.Results Nearly 1 million patients were included, and more than 27 million tests. The most ordered tests were for renal function (1463 per 1000 person-years), liver function (1063 per 1000 person-years), and full blood count (FBC; 996 per 1000 person-years). There was evidence of undertesting (compared with current guidelines) for HbA1c and albumin:creatinine ratio (ACR) or microalbumin, and potential overtesting of lipids, FBC, liver function, and thyroid function. Some GP practices had up to 27 times higher testing rates than others (HbA1c testing among patients with CKD).Conclusion Testing rates are no longer increasing, but they are not always within the guidelines for monitoring long-term conditions (LTCs). There was considerable variation by GP practice, indicating uncertainty over the most appropriate testing frequencies for different conditions. Standardising the monitoring of LTCs based on the latest evidence would provide greater consistency of access to monitoring tests.