Effectiveness of an Urban Emergency Department Call-Back System in the Successful Linkage to Treatment of Sexually Transmitted Infections

Lolar, Sara; Sherwin, Robert; Robinson, D.; Courage, Cheryl; Welch, Robert D.

doi:10.14423/smj.0000000000000273

Cited by 7 publications

(2 citation statements)

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“…Many patients in vulnerable communities may be more likely to utilize the ED for all care ( 2 ) and less likely to have an established primary care doctor. With such a large proportion of positive STI testing originating in the ED, programs and partnerships are needed to ensure patient follow up for timely treatment, counseling, and HIV prevention education ( 14 ). A major barrier to ED STI testing is concern about informing patients of positive test results after discharge from the ED ( 5 ), as STI tests can take up to 48 h to return a result.…”

Section: Discussionmentioning

confidence: 99%

Trends in STI testing and diagnosis rates during the COVID-19 pandemic at a large urban tertiary care center, and the role of the emergency department in STI care

Stanford

Mason

Friedman

2023

Front. Reprod. Health

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IntroductionThe COVID-19 pandemic has had profound effects on access to care, including outpatient sexually transmitted infection (STI) testing and treatment. Many vulnerable populations already relied on the emergency department (ED) for much of their care prior to the pandemic. This study examines trends in STI testing and positivity before and during the pandemic at a large urban medical center and evaluates the role of the ED in providing STI care.MethodsThis is a retrospective review of all gonorrhea, chlamydia, and trichomonas tests from November 1, 2018, through July 31, 2021. Demographic information and location and results of STI testing were extracted from the electronic medical record. Trends in STI testing and positivity were examined for 16 month periods before and after the COVID-19 pandemic started (March 15, 2020), with the latter divided into the early pandemic period (EPP: March 15 -July 31, 2020) and late pandemic period (LPP: August 1, 2020 - July 31, 2021).ResultsTests per month decreased by 42.4% during the EPP, but rebounded by July 2020. During the EPP, the proportion of all STI testing originating in the ED increased from 21.4% pre-pandemic to 29.3%, and among pregnant women from 45.2% to 51.5%. Overall STI positivity rate increased from 4.4% pre-pandemic to 6.2% in the EPP. Parallel trends were observed for gonorrhea and chlamydia individually. The ED represented 50.5% of overall positive tests, and as much as 63.1% of positive testing during the EPP. The ED was the source of 73.4% of positive tests among pregnant women, which increased to 82.1% during the EPP.ConclusionsSTI trends from this large urban medical center paralleled national trends, with an early decrease in positive cases followed by a rebound by the end of May 2020. The ED represented an important source of testing for all patients, and especially for pregnant patients, throughout the study period, but even more so early in the pandemic. This suggests that more resources should be directed towards STI testing, education, and prevention in the ED, as well as to support linkage to outpatient primary and obstetric care during the ED visit.

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Section: Discussionmentioning

confidence: 99%

Trends in STI testing and diagnosis rates during the COVID-19 pandemic at a large urban tertiary care center, and the role of the emergency department in STI care

Stanford

Mason

Friedman

2023

Front. Reprod. Health

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“…For common STIs like chlamydia, use of computerized surveys to assess risk and provide decision support to clinicians has shown promise to increase testing among high‐risk adolescents . We also need research to eliminate barriers to timely treatment including development of novel technologies that could provide rapid (e.g., point of care) and accurate test results and evaluation of system‐level changes to facilitate patient contact to share test results …”

Section: Discussionmentioning

confidence: 99%

A Research Agenda for Emergency Medicine–based Adolescent Sexual and Reproductive Health

Miller

Chernick

Goyal

et al. 2019

Academic Emergency Medicine

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Objective: The objective was to identify key questions for emergency medicine (EM)-based adolescent sexual and reproductive health and to develop an evidence-based research agenda. Methods:We recruited national content experts to serve as advisory group members and used a modified Delphi technique to develop consensus around actionable research questions related to EM-based adolescent reproductive and sexual health care. Author subgroups conducted literature reviews and developed the initial list of research questions, which were iteratively refined with advisory members. External stakeholders then independently rated each item for its importance in expanding the evidence base (1 = not important to 5 = very important) via electronic survey.Results: Our final list of 24 research questions included items that intersected all sexual and reproductive health topics as well as questions specific to human immunodeficiency virus/sexually transmitted infections (HIV/STIs), pregnancy prevention, confidentiality/consent, public health, and barriers and facilitators to care. External stakeholders rated items related to HIV/STI, cost-effectiveness, brief intervention for sexual risk reduction, and implementation and dissemination as most important. Conclusions:We identified critical questions to inform EM-based adolescent sexual and reproductive health research. Because evidence-based care has potential to improve health outcomes while reducing costs associated with HIV/STI and unintended pregnancy, funders and researchers should consider increasing attention to these key questions.A lthough preventable, sexually transmitted infections (STIs), human immunodeficiency virus (HIV) infection, and unintended pregnancy are significant and costly public health problems in the United States that disproportionately impact adolescents, especially racial and ethnic minorities and those From the

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Impact of doxycycline discharge kits on appropriate treatment of sexually transmitted infections among patients in the ED

Loudermilk,

Thiemann,

Senn

et al. 2025

The American Journal of Emergency Medicine

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Effectiveness of an Urban Emergency Department Call-Back System in the Successful Linkage to Treatment of Sexually Transmitted Infections

Cited by 7 publications

References 1 publication

Trends in STI testing and diagnosis rates during the COVID-19 pandemic at a large urban tertiary care center, and the role of the emergency department in STI care

Trends in STI testing and diagnosis rates during the COVID-19 pandemic at a large urban tertiary care center, and the role of the emergency department in STI care

A Research Agenda for Emergency Medicine–based Adolescent Sexual and Reproductive Health

Impact of doxycycline discharge kits on appropriate treatment of sexually transmitted infections among patients in the ED

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