Computer reminders for Chlamydia screening in general practice: a randomized controlled trial.
BACKGROUND
Chlamydia notifications are increasing in Australia, and the use of a computer alert prompting general practitioners to test young women is a potential way to increase opportunistic chlamydia testing. The aim of this trial was to determine the effectiveness of a computer alert in general practice on chlamydia testing in young women.


METHODS
In 2006, clinics (n = 68) in Melbourne, Australia were cluster randomized into 2 groups: the intervention group received a computerized alert advising the general practitioner to discuss chlamydia testing with their patient which popped up when the medical record of a 16- to 24-year-old woman was opened; the control group received no alert. The outcome was whether or not that patient received a chlamydia test at the level of a single consultation with an eligible patient. A mixed effects logistic regression model adjusting for clustering was used to assess the impact of the alert on the proportion of women tested for chlamydia during the trial period.


RESULTS
Testing increased from 8.3% (95% confidence interval (CI): 6.8, 9.8) to 12.2% (95% CI: 9.1, 15.3) (P < 0.01) in the intervention group, and from 8.8% (95% CI: 6.8, 10.7) to 10.6% (95% CI: 8.5, 12.7) (P < 0.01) in the control group. Overall, the intervention group had a 27% (OR = 1.3; 95% CI: 1.1, 1.4) greater increase in testing.


CONCLUSIONS
The results of this study suggest that alerts alone may not be sufficient to get chlamydia testing levels up sufficiently high enough to have an impact on the burden of chlamydia in the population but that they could be included as part of a more complex intervention.
Walker
Jennifer
J
University of Melbourne, Victoria, Australia. walker@unimelb.edu.au <walker@unimelb.edu.au>
Fairley
Christopher K
CK
Walker
Sandra M
SM
Gurrin
Lyle C
LC
Gunn
Jane M
JM
Pirotta
Marie V
MV
Carter
Rob
R
Hocking
Jane S
JS
D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D002689:Chlamydia; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology; D005194:Family Practice; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D010821:Physicians, Family; D017010:Reminder Systems; D012984:Software; D055815:Young Adult