Partner notification of chlamydia infection in primary care: randomised controlled trial and analysis of resource use.
OBJECTIVE
To evaluate the effectiveness of a practice nurse led strategy to improve the notification and treatment of partners of people with chlamydia infection.


METHODS
Randomised controlled trial.


METHODS
27 general practices in the Bristol and Birmingham areas.


METHODS
140 men and women with chlamydia (index cases) diagnosed by screening of a home collected urine sample or vulval swab specimen.


METHODS
Partner notification at the general practice immediately after diagnosis by trained practice nurses, with telephone follow up by a health adviser; or referral to a specialist health adviser at a genitourinary medicine clinic.


METHODS
Primary outcome was the proportion of index cases with at least one treated sexual partner. Specified secondary outcomes included the number of sexual contacts elicited during a sexual history, positive test result for chlamydia six weeks after treatment, and the cost of each strategy in 2003 sterling prices.


RESULTS
65.3% (47/72) of participants receiving practice nurse led partner notification had at least one partner treated compared with 52.9% (39/68) of those referred to a genitourinary medicine clinic (risk difference 12.4%, 95% confidence interval -1.8% to 26.5%). Of 68 participants referred to the clinic, 21 (31%) did not attend. The costs per index case were 32.55 pounds sterling for the practice nurse led strategy and 32.62 pounds sterling for the specialist referral strategy.


CONCLUSIONS
Practice based partner notification by trained nurses with telephone follow up by health advisers is at least as effective as referral to a specialist health adviser at a genitourinary medicine clinic, and costs the same. Trial registration Clinical trials: NCT00112255.
Low
Nicola
N
Department of Social Medicine, University of Bristol, Bristol BS8 2PR. low@ispm.unibe.ch
McCarthy
Anne
A
Roberts
Tracy E
TE
Huengsberg
Mia
M
Sanford
Emma
E
Sterne
Jonathan A C
JA
Macleod
John
J
Salisbury
Chris
C
Pye
Karl
K
Holloway
Aisha
A
Morcom
Andrea
A
Patel
Rita
R
Robinson
Suzanne M
SM
Horner
Paddy
P
Barton
Pelham M
PM
Egger
Matthias
M
D002690:Chlamydia Infections / Q000453:epidemiology / Q000451:nursing / Q000517:prevention & control*; D016358:Contact Tracing / Q000191:economics / Q000379:methods*; D003365:Costs and Cost Analysis; D004739:England / Q000453:epidemiology; D005194:Family Practice / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009722:Nurse Practitioners / Q000592:standards / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D013048:Specimen Handling / Q000191:economics / Q000706:statistics & numerical data