Reducing test request for anti-thyroglobulin and anti-thyroid peroxidase antibodies: Trends before and after interventions based on rejection rules and profile management

Abstract

Introduction: The objective of this study was to identify trends in requests for anti-thyroid peroxidase antibodies (TPOab) and anti-thyroglobulin antibodies (TGab) tests before and after applying set of interventions based on rejection rules and profile management. Materials and methods: Trend analysis was made at semester time intervals (from May-October 2010 to May-October 2017), before and after the intervention semester (May-October 2016). Number of tests (N) TPOab and TGab / 1000 total requests based on total N of both tests and total N of biochemical analysis laboratory requests, was calculated. To find out where the interventions had more impact we distinguished N of requests between Primary Care (PC) and Specialized Care (SC). A joinpoint regression analysis was used to determine time segments and time points in these indicators where the trend changed. Results: Trend analysis of the request of TPOab and TGab showed two clearly differentiated trend lines with a statistically significant Joinpoint (P < 0.001) with an increase in each semester from May 2010 of 7.4% and 7.5% respectively, to the semester of the interventions where there was a decrease of-45% and-61% located mainly in PC. Trend analysis in SC setting did not show any Joinpoint and any trend line. Conclusions: Results showed that applied interventions enabled change of trend for TPOab and TGab test requests, especially in PC where the interventions proved to be the most successful.