Performance of a quality-assessment scheme for blood glucose meters in general practice

SUMMARY. We describe our experience with a quality-assessment scheme for Glucometer users in General Practice based on simultaneous blood samples taken on filter paper strips and posted to the laboratory. The accuracy of results from these blood glucose meters outside the laboratory was below generally accepted laboratory standards; 30 % of results fell outside ± 20 % of the laboratory value. Only 58 % of the filter paper strips sent out were returned for analysis, suggesting a lack of awareness of the benefits and importance of such a scheme by the G.P. Glucometer users. In recent years there has been an increase in the availability of analytical instruments specifically designed for use outside the Clinical Biochemis-try laboratory. 1 In particular, there have been many reports on the value of blood glucose measurement in the diabetic clinic,2 in General Practice " and in the horne." Evaluation of dry reagent chemistry systems used with reflectance meters in the laboratory environment has indicated that they perform as well as conventional 'wet chemistry systems'.5,6 There are reports however, sug-gesting that analytical performance is not good when the meters are used outside the hospital laboratory. 5, 7-9 As a result of the growing concern among clinical and laboratory staff about the perform-ance of assays outside the laboratory, several groups have established quality-assessment (QA) schemes. " 10 These studies involved the regular distribution of either commercial freeze-dried sera'? or glucose solutions in ben-zoic acids to users of glucose meters. The results are compared with those obtained on identical samples analysed in the laboratory. The aim of our study was to assess the feasibility of using filter paper blood spots posted to the laboratory! ' for assessing meter "Present address and address for correspondence