General practice intervention to increase opportunistic screening for chlamydia

Merritt, Tony; Dürrheim, David N; Hope, Kirsty; Byron, Paul

doi:10.1071/sh07033

Cited by 19 publications

(41 citation statements)

References 6 publications

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“…The lower rates of testing within GPs and ACCHSs compared with SHSs could be due to a number of factors: patients declining testing; patients not being offered testing (staff lacking awareness of screening guidelines, due lack of time and awareness about chlamydia testing amongst clinic staff, or sensitivities regarding sexual health issues); or other clinical priorities [24-26]. In order to achieve higher chlamydia testing rates in GP and ACCHS settings, supportive quality improvement strategies are warranted [27,28] as well as initiatives such as offering a test to all patients prior to the consultation [29] Quality improvement audits are a key feature of the Closing the Gap funding initiatives particularly involving ACCHSs [30] but do not currently explore STI testing patterns.…”

Section: Discussionmentioning

confidence: 99%

Chlamydia among Australian Aboriginal and/or Torres Strait Islander people attending sexual health services, general practices and Aboriginal community controlled health services

Ward

Goller

Ali

et al. 2014

BMC Health Serv Res

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BackgroundChlamydia infections are notified at much higher rates in Aboriginal and/or Torres Strait Islander people compared to non-Indigenous people. The Australian Collaboration Chlamydia Enhanced Sentinel Surveillance System (ACCESS) was established to complement population-based surveillance.MethodsWe describe patient demographics, completeness of recording of Aboriginal and/or Torres Strait Islander (‘Aboriginal’) status, chlamydia testing rates and positivity rates from the Aboriginal Community Controlled Health Service (ACCHSs), General Practice (GP) clinics and Sexual Health Services (SHSs) networks in ACCESS during 2009. Data were extracted from electronic medical records of each participating health service for consultations with patients aged 16–29 years and for chlamydia testing and positivity.ResultsData were included from 16–29 year olds attending six ACCHSs (n = 4,950); 22 SHSs (n = 20,691) and 25 GP clinics (n = 34,462). Aboriginal status was unknown for 79.3% of patients attending GP clinics, 4.5% attending SHSs and 3.8% of patients attending ACCHSs. Chlamydia testing rates among Aboriginal patients were 19.8% (95%CI:18.6%-21.0%) at ACCHSs, 75.5% (95% CI:72.5%-78.4%) at SHSs and 4.3% (95% CI: 2.6%-6.6%) at GP clinics. Positivity rates were highest in Aboriginal patients tested at SHSs at 22.7% (95% CI:19.5%-26.2%), followed by 15.8% (95% CI:3.8%-43.4%) at GP clinics and 8.6% at ACCHSs (95% CI:7.9%-12.4%). This compared with non-Indigenous patients positivity rates at SHSs of 12.7% (95% CI:12.2-13.2%); 8.6% (7.2%-11.3%) at GP clinics and 11.3% at ACCHSs (95% CI:15.4%-24.9%).ConclusionsHigher chlamydia positivity in Aboriginal people across a range of clinical services is reflected in national notification data. Targeted efforts are required to improve testing rates in primary care services; to improve identification of Aboriginal patients in mainstream services such as GP clinics; and to better engage with young Aboriginal Australians.

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Section: Discussionmentioning

confidence: 99%

Chlamydia among Australian Aboriginal and/or Torres Strait Islander people attending sexual health services, general practices and Aboriginal community controlled health services

Ward

Goller

Ali

et al. 2014

BMC Health Serv Res

View full text Add to dashboard Cite

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“…Approximately 7% of attendees were tested within a 12-month period compared with 25% and 40% retested by 4 and 12 months of a positive test, respectively. This may reflect annual testing being largely opportunistic in GP clinics24 and subject to numerous barriers—particularly time constraints and when unrelated to the presenting complaint 25. In contrast, retesting is more likely to be done in the context of a sexual health consultation and after the individual is established at risk.…”

Section: Discussionmentioning

confidence: 99%

Missed opportunities—low levels of chlamydia retesting at Australian general practices, 2008–2009

et al. 2012

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“…Modelling data has shown that testing rates need to be increased to 30% or more in order to reduce the prevalence of chlamydia [8]. Barriers to testing by GPs include lack of time, discomfort with sexual health issues [9] and lack of knowledge about the benefits of chlamydia screening [10]. …”

Section: Introductionmentioning

confidence: 99%

Improving chlamydia knowledge should lead to increased chlamydia testing among Australian general practitioners: a cross-sectional study of chlamydia testing uptake in general practice

et al. 2014

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BackgroundFemale general practitioners (GPs) have higher chlamydia testing rates than male GPs, yet it is unclear whether this is due to lack of knowledge among male GPs or because female GPs consult and test more female patients.MethodsGPs completed a survey about their demographic details and knowledge about genital chlamydia. Chlamydia testing and consultation data for patients aged 16-29 years were extracted from the medical records software for each GP and linked to their survey responses. Chi-square tests were used to determine differences in a GP’s knowledge and demographics. Two multivariable models that adjusted for the gender of the patient were used to investigate associations between a GP and their chlamydia testing rates ― Model 1 included GPs’ characteristics such as age and gender, Model 2 excluded these characteristics to specifically examine any associations with knowledge.ResultsFemale GPs were more likely than male GPs to know when to re-test a patient after a negative chlamydia test (18.8% versus 9.7%, p = 0.01), the correct symptoms suggestive of PID (80.5% versus 67.8%, p = 0.01) and the correct tests for diagnosing PID (57.1% versus 42.6%, p = 0.01). Female GPs tested 6.5% of patients, while male GPs tested 2.2% (p < 0.01). Model 1 found factors associated with chlamydia testing were being a female GP (OR = 2.5, 95% CI: 1.9, 3.3) and working in a metropolitan clinic (OR = 3.2; 95% CI: 2.4, 4.3). Model 2 showed that chlamydia testing increased as knowledge of testing guidelines improved (3-5 correct answers – AOR = 2.0, 95% CI: 1.0, 4.2; 6+ correct answers – AOR = 2.9, 95% CI: 1.4, 6.2).ConclusionsHigher rates of chlamydia testing are strongly associated with GPs who are female, based in a metropolitan clinic and among those with more knowledge of the recommended guidelines. Improving chlamydia knowledge among male GPs may increase chlamydia testing.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0584-2) contains supplementary material, which is available to authorized users.

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General practice intervention to increase opportunistic screening for chlamydia

Cited by 19 publications

References 6 publications

Chlamydia among Australian Aboriginal and/or Torres Strait Islander people attending sexual health services, general practices and Aboriginal community controlled health services

Chlamydia among Australian Aboriginal and/or Torres Strait Islander people attending sexual health services, general practices and Aboriginal community controlled health services

Missed opportunities—low levels of chlamydia retesting at Australian general practices, 2008–2009

Improving chlamydia knowledge should lead to increased chlamydia testing among Australian general practitioners: a cross-sectional study of chlamydia testing uptake in general practice

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