title: Screening for Chlamydia trachomatis at the time of routine Pap smear in general practice: a cluster randomised controlled trial.
abstract: OBJECTIVE
  To determine whether asking general practitioners to offer chlamydia screening at the same time as Pap screening increases chlamydia screening rates.
  
  
  METHODS
  A pragmatic cluster randomised controlled trial.
  
  
  METHODS
  Doctors from 31 general practices in the Australian Capital Territory performing more than 15 Pap smear screens per year, and all women aged 16-39 years attending those practitioners between 1 November 2004 and 31 October 2005.
  
  
  METHODS
  Doctors in the intervention practices were asked to routinely offer combined chlamydia and Pap screening to eligible women; doctors in the control practices were asked to implement screening guidelines based on a risk assessment of the individual patient (ie, usual practice).
  
  
  METHODS
  Chlamydia screening rate per visit.
  
  
  RESULTS
  There were 26 876 visits by eligible women during the study period: 16 082 to intervention practices and 10 794 to control practices. Chlamydia screening occurred during 6.9% (95% CI, 6.5%-7.3%) of visits to intervention practices and 4.5% (95% CI, 4.1%-4.9%) of visits to control practices. After controlling for clustering and potential confounders, there were twofold greater odds of chlamydia screening occurring during a visit by an eligible woman to an intervention practice than to a control practice (adjusted odds ratio, 2.1 [95% CI, 1.3-3.4]).
  
  
  CONCLUSIONS
  Combining chlamydia and Pap screening increases the rate of chlamydia screening in general practice. Implementing this approach would require little additional infrastructure support in settings where a cervical screening program already exists.
authors.affiliation: Academic Unit of Internal Medicine, Australian National University, Canberra, ACT, Australia. frank.bowden@act.gov.au
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Bowden
authors.forename: Marian J
authors.initials: MJ
authors.lastname: Currie
authors.forename: Helen
authors.initials: H
authors.lastname: Toyne
authors.forename: Clare
authors.initials: C
authors.lastname: McGuiness
authors.forename: Lynette L
authors.initials: LL
authors.lastname: Lim
authors.forename: James R
authors.initials: JR
authors.lastname: Butler
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Glasgow
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology; D002692:Chlamydia trachomatis; D005194:Family Practice; D005260:Female; D006801:Humans; D008403:Mass Screening; D065006:Papanicolaou Test; D015995:Prevalence; D014626:Vaginal Smears