A missed opportunity--lessons learnt from a chlamydia testing observation study in general practice.
BACKGROUND
Chlamydia is the most frequently notified sexually transmissible infection in Australia and occurs most commonly in young people. Up to 80% of chlamydia infections are asymptomatic. The Royal Australian College of General Practitioners recommends annual chlamydia testing for all sexually active people aged less than 25 years. This study explored potential structural or procedural barriers that might inhibit chlamydia testing in young women in general practice.


METHODS
The chlamydia testing pathways of 12 general practices were examined using a comprehensive practice assessment tool. The pathways of these clinics were compared to a best practice testing pathway, and clinics were offered tailored advice to help improve their practice pathway.


RESULTS
Clinics were followed up at 2 months. Little change to existing practices had been made.


CONCLUSIONS
Clinics employing a practice manager were better equipped to enable systems for chlamydia testing to be developed. Results are discussed in light of May's normalisation theory, which states that changing practices requires shared understanding and commitment by all staff. It is unlikely that chlamydia testing rates in general practice will reach the levels required to reduce the burden of chlamydia without a coordinated clinic level approach.
General Practice and Primary Health Care Academic Centre, University of Melbourne, Victoria, Australia. m.temple-smith@unimelb.edu.au
Meredith
M
Temple-Smith
Marie
M
Pirotta
Jessica
J
Kneebone
Kathleen
K
McNamee
Christopher
C
Fairley
Jade
J
Bilardi
Jane
J
Hocking
D000293:Adolescent; D002689:Chlamydia / Q000302:isolation & purification*; D002690:Chlamydia Infections / Q000175:diagnosis*; D005260:Female; D058006:General Practice; D006801:Humans; D019370:Observation; D010818:Practice Patterns, Physicians'; D014739:Victoria; D055815:Young Adult