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P5.017 The Australian Chlamydia Control Effectiveness Pilot (ACCEPt): Early Results from a Randomised Trial of Annual Chlamydia Screening in General Practise
  1. J Hocking1,
  2. M Temple-Smith1,
  3. R Guy2,
  4. F Kong1,
  5. N Low3,
  6. B Donovan2,
  7. M Law2,
  8. J Kaldor2,
  9. J Gunn1,
  10. C Fairley1,4
  1. 1University of Melbourne, Carlton, Australia
  2. 2Kirby Institute, Sydney, Australia
  3. 3University of Bern, Bern, Switzerland
  4. 4Melbourne Sexual Health Centre, Carlton, Australia

Abstract

Background ACCEPt is a cluster randomised controlled trial to evaluate annual opportunistic chlamydia screening for 16–29 year olds in general practise (GP). Towns in which GP clinics are enrolled, are randomised to receive a multifaceted intervention to increase chlamydia testing or continue usual practise. The primary outcome is change in chlamydia prevalence amongst GP patients in each town. We report some early results on testing uptake, a secondary outcome.

Methods From July 2010-December 2011, we enrolled 787 GPs in 150 clinics (response rate > 80%) in 54 towns. Chlamydia testing rates (the proportion who consult a GP and have a test during 12 months) and re-testing rates (proportion who are re-tested within 12 (±3) months following a negative or within 3 months following a positive test) were calculated. We compared testing between intervention and control towns from July 2011 to Sept 2012. All analyses are adjusted for intracluster correlation within clinics.

Result We analysed a total of 21,335 tests in intervention and 13,992 in control clinics. In clinics with 12–15 months intervention period (11 clinics), annual testing has increased by 47% (from 15.1% to 22.3%) in females, 88% (from 6.3% to 11.9%) in males and 61% overall (from 11.6% to 18.7%). After increasing from 7.9% to 11.8% in the first 12 months, control clinic testing dropped to 9.7% in 2012. The relative risk of testing in intervention compared with control clinics is 1.9 (95% CI: 1.8, 2.0). Of 2876 testing positive, 38% retest within 3 months and of those testing negative, 22% retest within 12 months in both trial arms.

Conclusions Nearly twice as many are being tested in the intervention and testing rates are increasing. The high participation rate of clinics in all towns puts the study in a strong position to determine if a pragmatic intervention can reduce chlamydia prevalence.

  • chlamydia screening
  • RCT

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