Interactive workshops increase chlamydia testing in primary care--a controlled study.
BACKGROUND
Primary care clinicians suggest that staff education is needed to increase chlamydia testing appropriately.


OBJECTIVE
To determine if interactive workshops and modified laboratory request forms could increase testing and case detection.


METHODS



METHODS
Prospective cluster randomized controlled study, using modified Zelen's design, examining the effect of workshops and modified request forms on primary care clinicians' chlamydia specimen submission and case positivity rate.


METHODS
82 general practices in six geographical clusters within five primary care trusts (PCTs) in Gloucestershire and County Durham and Darlington.


METHODS
Practices within geographical clusters were randomly assigned to workshops on chlamydia or a control consisting of comparable workshops on the management of urinary symptoms, held in PCT-protected learning time. Half the practices were randomized to receive modified laboratory request forms. Staff were unaware that they were part of a study.


RESULTS
Interactive workshops increased chlamydia testing in 16- to 24-year-old women by 33% in intervention practices compared to controls with effect persisting at 10 months (P = 0.003). No associated rise in the number of chlamydia infections was detected (P = 0.91), suggesting that increased testing may have occurred in a lower risk population. Modified forms did not change test submission (P = 0.75).


CONCLUSIONS
Interactive workshops for general practices can be used to successfully increase chlamydia-testing rates. Chlamydia detection rates will need to be monitored as this type of educational programme may not increase absolute numbers of chlamydia infections detected, if patients at lower risk of infection are inappropriately tested. Other interventions may need to be combined with the workshops, to reach sufficiently high chlamydia screening rates to significantly reduce prevalence of chlamydial infection.
McNulty
Cliodna Am
CA
Health Protection Agency Primary Care Unit, Microbiology Department, Gloucestershire Royal Hospital, Great Western Road, Gloucester GL13NN, UK. cliodna.mcnulty@hpa.org.uk
Thomas
Michael
M
Bowen
Joanne
J
Buckley
Charles
C
Charlett
Andre
A
Gelb
David
D
Foy
Chris
C
Sloss
John
J
Smellie
Stuart
S
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001291:Attitude of Health Personnel; D002690:Chlamydia Infections / Q000175:diagnosis*; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D004496:Education, Continuing / Q000379:methods*; D005194:Family Practice / Q000193:education* / Q000379:methods; D005260:Female; D005568:Forms and Records Control / Q000379:methods; D006801:Humans; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D015397:Program Evaluation; D011446:Prospective Studies; D006113:United Kingdom; D014626:Vaginal Smears