title: Who attends primary care services prior to attendance at genitourinary services and what level of care have they received?
abstract: OBJECTIVE
  To determine the proportion of patients initially attending primary care services and describe the care received prior to attending genitourinary medicine (GUM) clinics.
  
  
  METHODS
  A cross-sectional survey of 1000 new patients attending GUM services in Cornwall between June and December 2006. Patients were asked during consultation whether they had attended primary care before coming and what examination, investigation and management had been carried out there.
  
  
  RESULTS
  35% (348/1000) of patients had attended primary care initially. Genital examination had been carried out in primary care on 60% (111/185) female and 58% (93/159) male patients (p = 0.78). Chlamydia testing had been carried out in 27% (46/171) female and 6% (8/139) male patients (p<0.005). 33% (100/301) patients seen in primary care had been offered treatment. 74% (68/92) patients with genital warts had been correctly diagnosed in primary care and 9% (8/92) of these offered treatment.
  
  
  CONCLUSIONS
  The majority of these patients, including those given a diagnosis and/or offered treatment in primary care, had not had a chlamydia test or any other investigations. With the potential "fall out" of patients between primary care and GUM services, this may represent a missed opportunity to detect and appropriately manage sexually transmitted infections.
authors.affiliation: Department of GU medicine, Royal Cornwall Hospital, Truro, TR1 3LJ, UK. rachn2000@yahoo.com
authors.forename: R
authors.initials: R
authors.lastname: Neale
authors.forename: F
authors.initials: F
authors.lastname: Keane
authors.forename: N
authors.initials: N
authors.lastname: Saulsbury
authors.forename: L
authors.initials: L
authors.lastname: Haddon
authors.forename: R
authors.initials: R
authors.lastname: Osborne
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004739:England; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D012749:Sexually Transmitted Diseases / Q000628:therapy*; D014686:Venereology / Q000706:statistics & numerical data*