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Improving clinical practice and service delivery
P137 The effect of a dedicated syphilis clinic on syphilis management outcomes
  1. K Fernando,
  2. K Hall,
  3. J D C Ross
  1. Whittall Street Clinic, Birmingham, UK

Abstract

Background Patients with syphilis are frequently managed within general sexual health clinics. Although the incidence of syphilis has recently increased, it remains a relatively uncommon STI and individual clinic staff may see only a small number of cases. It is not known to what extent the use of a dedicated “syphilis clinic,” where expertise is concentrated, can lead to an improvement in management. A dedicated specialist trainee/health advisor delivered syphilis clinic was introduced in April 2011 to optimise the care of patients with syphilis.

Aim To assess, using outcomes from the UK syphilis management guidelines, the effect on patient care of introducing a dedicated “syphilis clinic.”

Methods A case record review of patients with syphilis before (control arm) and after (intervention arm) the introduction of a dedicated syphilis clinic between October 2010 and September 2011.

Results 101 patients were analysed, 30 in the intervention, and 71 in the control arm. Repeat testing prior to treatment was undertaken in 19 (63.3%) of the intervention arm and 45 (63.4%) of controls [p=0.99]. Receipt of appropriate antibiotic treatment was observed in 28 (93.3%) of the intervention arm and 65 (91.5%) of controls [p=0.73]. The mean number of follow-up visits required was 1.23 (intervention arm) and 3.3 (controls) [p=0.334]. Of significance, however, was consultation length, being shorter in the intervention vs the control arm—mean duration of 49.7 min cf. 61.8 min (p=0.034).

Discussion In addition to reduced consultation duration, continuity of physician involvement and optimisation of patient care are key potential benefits of a dedicated syphilis clinic.

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