Quality of Life Changes in Respiratory Infection Trajectory with Point of Care Testing During Clinical Consultation.

BACKGROUND: This study evaluates the impact of a point-of-care (POC) testing strategy and subsequent treatments for respiratory tract infections (RTIs) on patients' health-related quality of life (QoL). MATERIALS AND METHODS: The PRUDENCE trial, with a sample of 2639 patients, showed that a POC testing strategy for RTIs (C-reactive protein, group A streptococcus, and influenza A/B, with optional SARS-CoV-2 testing) did not reduce antibiotic prescribing nor had a measurable impact on time to patient recovery compared to usual care. However, differences in patient-reported QoL may still exist, as utility can capture more subtle changes in symptom burden and well-being. The EQ-5D-5L questionnaire was completed by PRUDENCE trial patients at days 1, 14, and 28 of follow-up. Quality-adjusted life-year (QALY) gains were estimated. Static and dynamic analyses were performed to assess changes in utility values. RESULTS: No statistically significant differences in utility scores were observed between the usual care and POC testing groups at any time point during the 28-day study period. However, both groups demonstrated statistically significant improvements in patient-reported utility scores over the 28-day period, corresponding to gains of 0.00502 QALYs in the usual care group and 0.00525 QALYs in the POC testing group. These improvements were already apparent by day 14 of follow-up. CONCLUSION: Improvements in utility scores over time were similar in both groups and likely reflected the natural clinical recovery from RTIs rather than the effect of the diagnostic strategy itself. Measures such as symptom relief, full recovery and side effects may better capture the intervention's impact. TRIAL REGISTRATION NUMBER: ISRCTN13336322.