Clinician education, advice and SMS/text reminders improve test of reinfection rates following diagnosis of Chlamydia trachomatis or Neisseria gonorrhoeae : before and after study in primary care.

Autor:	Rose SB; Primary Health Care and General Practice, University of Otago, Wellington, New Zealand sally.rose@otago.ac.nz., Garrett SM; Primary Health Care and General Practice, University of Otago, Wellington, New Zealand., Hutchings D; Wellington Sexual Health Service, Wellington, New Zealand., Lund K; Wellington Sexual Health Service, Wellington, New Zealand., Kennedy J; Wellington Sexual Health Service, Wellington, New Zealand., Pullon SRH; Primary Health Care and General Practice, University of Otago, Wellington, New Zealand.
Jazyk:	angličtina
Zdroj:	BMJ sexual & reproductive health [BMJ Sex Reprod Health] 2019 Oct 18. Date of Electronic Publication: 2019 Oct 18.
DOI:	10.1136/bmjsrh-2018-200185
Abstrakt:	Background: Evidence-based guidelines for the management of Chlamydia trachomatis and Neisseria gonorrhoeae recommend testing for reinfection 3-6 months following treatment, but retesting rates are typically low. Methods: Participants included six primary care clinics taking part in a pilot study of strategies designed to improve partner notification, follow-up and testing for reinfection. Rates of retesting between 6 weeks and 6 months of a positive chlamydia or gonorrhoea diagnosis were compared across two time periods: (1) a historical control period (no systematic approach to retesting) and (2) during an intervention period involving clinician education, patient advice about reinfection risk reduction and retesting, and short messaging service/text reminders sent 2-3 months post-treatment inviting return for retesting. Retesting was calculated for demographic subgroups (reported with 95% CI). Results: Overall 25.4% (61 of 240, 95% CI 20.0 to 31.4) were retested during the control period and 47.9% (116 of 242, 95% CI 43.2 to 55.1) during the intervention period. Retesting rates increased across most demographic groups, with at least twofold increases observed for men, those aged 20-29 years old, and Māori and Pasifika ethnic groups. No significant difference was observed in repeat positivity rates for the two time periods, 18% (11 of 61) retested positive during the control and 16.4% (19 of 116) during the intervention period (p>0.05). Conclusions: Clinician and patient information about retesting and a more systematic approach to follow-up resulted in significant increases in proportions tested for reinfection within 6 months. These simple strategies could readily be implemented into primary healthcare settings to address low rates of retesting for bacterial sexually transmitted infections. Trial Registration Number: ACTRN12616000837426. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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