title: Missed opportunities--low levels of chlamydia retesting at Australian general practices, 2008-2009.
abstract: OBJECTIVE
  Chlamydia reinfection is common and increases the risk of reproductive complications. Guidelines for Australian general practitioners recommend retesting 3-12 months after a positive result but not before 6 weeks. The authors describe retesting rates among 16-29-year-old patients diagnosed as having chlamydia at 25 general practice clinics participating in the Australian Collaboration for Chlamydia Enhanced Sentinel Surveillance system.
  
  
  METHODS
  The authors calculated annual testing and positivity rates for 16-29-year-olds attending in 2008-2009, re-attendance and retesting rates within <6 weeks, 1.5-4 months and 1.5-12 months of a positive test in 2008-2009 and positivity at retest (where results were available). Results There were 50,408 individuals (60.4% women) who attended in 2008-2009. Annually, 7.4% and 7.3% were tested for chlamydia, of whom 9.1% and 8.0% tested positive, respectively. Within 1.5-4 months of a positive test, 24.6% re-attended and were retested (19% tested positive), 31.6% re-attended and were not retested and 43.9% did not re-attend. Within 1.5-12 months, 40% re-attended and were retested (16% tested positive), 40% re-attended and were not retested and 20% did not re-attend. Of individuals re-attending in 1.5-12 months but not retested, 50% had re-attended three or more times in the period. Within 6 weeks of a positive test, 25% were retested.
  
  
  CONCLUSIONS
  A high proportion of 16-29-year-olds re-attended general practices in the recommended retest periods, but retesting rates were low and multiple missed opportunities were common. The findings highlight the need for strategies such as electronic clinician prompts, patient recall systems and promotion of retesting guidelines.
authors.affiliation: Centre for Population Health, Burnet Institute, 85 Commercial Road, Melbourne, Victoria 3004, Australia. annab@burnet.edu.au
authors.forename: Anna L
authors.initials: AL
authors.lastname: Bowring
authors.forename: Maelenn
authors.initials: M
authors.lastname: Gouillou
authors.forename: Rebecca
authors.initials: R
authors.lastname: Guy
authors.forename: Fabian Y S
authors.initials: FY
authors.lastname: Kong
authors.forename: Jane
authors.initials: J
authors.lastname: Hocking
authors.forename: Marie
authors.initials: M
authors.lastname: Pirotta
authors.forename: Clare
authors.initials: C
authors.lastname: Heal
authors.forename: Tom
authors.initials: T
authors.lastname: Brett
authors.forename: Basil
authors.initials: B
authors.lastname: Donovan
authors.forename: Margaret
authors.initials: M
authors.lastname: Hellard
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D002689:Chlamydia / Q000302:isolation & purification*; D005260:Female; D058006:General Practice / Q000379:methods* / Q000706:statistics & numerical data; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006302:Health Services Research; D006801:Humans; D008219:Lymphogranuloma Venereum / Q000175:diagnosis* / Q000453:epidemiology*; D008297:Male; D013997:Time Factors; D055815:Young Adult