Home Visit Criteria 2025
We are reaching out to provide a reminder about the appropriate use of our home visit phlebotomy service. Our mobile service exists to support patients who are genuinely unable to attend a collection centre due to medical, mobility, or other significant limitations. We appreciate your partnership in helping us ensure this service remains available for those who need it most.
Recently, we have observed an increase in the volume of home visit requests, including cases where patients have declined further visits, noting that they have had multiple blood draws in a short timeframe. In some instances, the frequency and clinical justification for these visits appear to fall outside usual practice guidelines.
We kindly ask that you:
- Re-familiarise yourself with our written home visit criteria to ensure all requests for your patients meet the eligibility for home-based collections
- Consider whether repeat testing is clinically necessary, especially within short intervals
- Confirm with the patient that they are aware of and consent to the scheduled home visit
- If you are unsure whether a home visit is appropriate, please don’t hesitate to contact our team to discuss.
Thank you for your ongoing support and cooperation in helping us deliver an efficient and patient-centred service.
Changes to Anti-Streptolysin reporting for Awanui Laboratories
Anti-streptolysin O (ASO) antibodies are used to detect recent infection with Streptococcus pyogenes (Group A Streptococcus), especially in the diagnosis of post-streptococcal complications like rheumatic fever or post-streptococcal glomerulonephritis. However, interpreting ASO levels is complex, and there are no universally accepted “normal” or diagnostic cut-off levels.
Children are more frequently exposed to streptococcal infections have higher ASO levels than adults and because they reflect community exposure to S. pyogenes. In populations with high endemic rates of streptococcal infection, population-based “normal” levels are higher than in low-exposure areas. This makes it impossible to have single normal/abnormal cut-off value.
ASO levels typically rise 1–3 weeks after infection, peak at 3–5 weeks, and then decline over months. A high ASO may reflect a past rather than current infection. Conversely, testing too early may yield falsely low titres.
Some individuals have robust antibody responses, while others have minimal ASO elevation despite infection. Immune response variability means a fixed threshold could miss true positives or generate false positives.
A rising titre (i.e., a fourfold increase over 2–4 weeks) is more informative than a single value.
For these reasons, Awanui laboratories will not be providing “normal ranges” or flag “abnormal” results. ASO levels have to be interpreted in light of the clinical likelihood of rheumatic fever or glomerulonephritis, and the report will provide a link to the Rheumatic Fever Guidelines to help with interpretation.