title: Testing and screening for chlamydia in general practice: a cross-sectional analysis.
abstract: OBJECTIVE
  Chlamydia screening is widely advocated. General practice registrars are an important stage of clinical behaviour development. This study aimed to determine rates of, and factors associated with, registrars' chlamydia testing including asymptomatic screening.
  
  
  METHODS
  A cross-sectional analysis of data from Registrars Clinical Encounters in Training (ReCEnT), a cohort study of registrars' consultations. Registrars record details of 60 consecutive consultations in each GP-term of training. Outcome factors were chlamydia testing, asymptomatic screening and doctor-initiated screening.
  
  
  RESULTS
  Testing occurred in 2.5% of 29,112 consultations (398 registrars) and in 5.8% of patients aged 15-25. Asymptomatic screening comprised 47.5% of chlamydia tests, and 55.6% of screening tests were doctor-initiated. Chlamydia testing was associated with female gender of doctor and patient, younger patient age, and patients new to doctor or practice. Asymptomatic screening was associated with practices where patients incur no fees, and in patients new to doctor or practice. Screening of female patients was more often doctor-initiated.
  
  
  CONCLUSIONS
  GP registrars screen for chlamydia disproportionately in younger females and new patients.
  
  
  CONCLUSIONS
  Our findings highlight potential opportunities to improve uptake of screening for chlamydia, including targeted education and training for registrars, campaigns targeting male patients, and addressing financial barriers to accessing screening services.
authors.affiliation: Discipline of General Practice, Faculty of Health and Medicine, University of Newcastle, New South Wales.
authors.forename: Allison
authors.initials: A
authors.lastname: Thomson
authors.forename: Simon
authors.initials: S
authors.lastname: Morgan
authors.forename: Kim
authors.initials: K
authors.lastname: Henderson
authors.forename: Amanda
authors.initials: A
authors.lastname: Tapley
authors.forename: Neil
authors.initials: N
authors.lastname: Spike
authors.forename: John
authors.initials: J
authors.lastname: Scott
authors.forename: Mieke
authors.initials: M
authors.lastname: van Driel
authors.forename: Parker
authors.initials: P
authors.lastname: Magin
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001291:Attitude of Health Personnel; D002689:Chlamydia / Q000302:isolation & purification*; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005194:Family Practice; D005260:Female; D058006:General Practice; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012042:Registries; D055815:Young Adult
keywords: chlamydia; general practice; graduate medical education; reproductive health; screening