What is the problem?
The number of blood tests performed in the NHS is increasing. Over half of these blood tests take place in general practice to monitor long-term conditions (LTC).
Testing blood can be unnecessary, may cause distress and lead to further tests and treatments that may not be needed. However, not testing may miss things that might be wrong.
Current guidelines on what tests people with LTC should have to monitor their condition are based on expert opinion rather than research evidence.
Previous studies have found inconsistencies in the ordering of blood tests across GP surgeries.
What is the Test Smart intervention?
To address the inconsistencies found in previous studies, we have developed evidence-based lists of tests for monitoring patients with diabetes, high blood pressure and kidney disease.
We have also developed resources to help patients understand what their blood tests mean for their health. Together these make up the Test Smart strategy.
What we will do
We will implement the Test Smart strategy in 10 GP practices and compare the rates of testing before and after implementation with rates of testing in 10 GP practices that are not using the strategy.
We will monitor hospitalisations across all practices to see whether there are any risks associated with having fewer tests.
We will also look at patient outcomes including ‘patient activation’, to see if patients feel more in control of their health when they are given more information to help them understand their monitoring tests.
Study design
The Test Smart study is a cluster randomised controlled trial (cRCT) with a qualitative sub-study and economic evaluation. For more information on the study design, outcome measures, and analysis, please visit the ISRCTN registry.
Sharing our findings
Our findings will be published in peer-reviewed healthcare journals, and a summary will be shared with those involved in the delivery and organisation of care for people with long-term conditions. We will collaborate with relevant patient groups and our patient advisors on the most effective ways to communicate our findings to patients.
