4.6 Article

Direct-to-consumer testing - benefits for consumers, people with disease and public health

Journal

CLINICAL CHEMISTRY AND LABORATORY MEDICINE
Volume 61, Issue 4, Pages 703-708

Publisher

WALTER DE GRUYTER GMBH
DOI: 10.1515/cclm-2023-0007

Keywords

direct-to-consumer (DTC) testing; evidence-based medicine; in-vitro diagnostics; public health; self-management

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Direct-to-consumer (DTC) tests refer to any in-vitro diagnostic (IVD) tests or medical tests using IVD or medical devices that are sold directly to consumers without involvement of a healthcare provider (HCP). DTC tests fulfill various customer needs and can provide advantages such as rapid decision-making, monitoring chronic conditions, saving time and reducing consultations, screening for asymptomatic diseases, and ensuring privacy. In addition, DTC tests can reduce cost, expand access to care, and support healthcare systems in extraordinary circumstances.
Direct-to-consumer (DTC) tests can be defined as any in-vitro diagnostic (IVD) test or, more broadly, any medical test using an IVD or medical device, that is marketed directly to consumers without involvement of a health care provider (HCP). Examples are pregnancy tests, alcohol breath tests, blood pressure measurements (medical device), coagulation tests (INR), self-monitoring of blood glucose, continuous glucose monitoring (medical device), HIV tests, HPV tests, SARS-CoV-2 antigen tests, or genetic tests. DTC tests fulfil various customer needs such as making rapid decisions (e.g. glucose monitoring for insulin dosing, SARS-CoV-2 antigen test, hormone test identifying fertile days, alcohol test), monitoring chronic conditions between consultations (e.g. diabetes, lipidaemia, hypertension), saving time and reducing consultations (e.g. INR, SARS-CoV-2 antigen test, blood pressure monitoring), screening for disease when no symptoms are present (e.g. occult blood, cholesterol, triglycerides, SARS-CoV2 antigen test), or maintaining privacy (e.g. pregnancy test, HIV test, HPV test, certain genetic tests). Further, DTC tests can reduce cost and expand access to care in countries with limited resources and can support healthcare systems in extraordinary circumstances such as a pandemic. Valid concerns about DTC testing need to be described, addressed and resolved with the help of authorities and regulators in collaboration with HCP and should not detract from the advantages DTC tests can provide. HCP should play a more prominent role in educating the public through mass media and social media on the proper use of DTC tests and help to pinpoint problem areas.

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