Point-of-care testing for non-communicable diseases and health literacy outcomes: a systematic review

BACKGROUND: Health literacy responsiveness has been identified as a key action area in reducing the burden of non-communicable diseases (NCDs), which are a leading cause of death worldwide. Point-of-care (POC) testing has the potential to improve health literacy in individuals and communities. This systematic review aimed to synthesise the literature regarding POC testing for NCDs and health literacy outcomes. METHODS: A systematic search was conducted across seven databases, Medline (via OVID), PsycINFO, Emcare, Scopus, ProQuest (Health databases), CINAHL, and Web of Science, between May 2018 and May 2023. Studies that investigated the utilisation of a POC device for measurement of NCD markers, and reported at least one outcome measure of health literacy in individuals over 10 years old were eligible for inclusion. Risk of bias in included studies was assessed using the Mixed Methods Appraisal Tool (MMAT). Results were mapped to the five WHO health literacy actions through narrative synthesis. RESULTS: Thirteen studies were eligible for inclusion, primarily investigating POC assessment of diabetes, with some examining lipids or coagulation. Study cohorts were geographically limited to eight countries in predominantly high-income settings. Following POC testing relevant to diabetes and cardiovascular contexts, patients reported an enhanced understanding of health, motivation to make positive lifestyle changes, increased quality of life and decreased worry, increased confidence, and improved health markers. CONCLUSION: The findings from this review suggest that POC testing may support improvements in individual health literacy outcomes relevant to NCD management, specifically in diabetes and cardiovascular contexts. These findings reflect the potential of POC testing to contribute to more responsive health systems, by improving accessibility, results delivery, and communication of health information. However, the evidence base is limited in scope, and findings may not necessarily be generalisable. Future studies should prioritise examining a broader range of NCDs, particularly in underdeveloped regions, and employ specific validated health literacy tools. PROSPERO REGISTRATION: CRD42022348011.