Background Failure to communicate sexually transmitted infection (STI) results to emergency department (ED) patients is a barrier to appropriate STI treatment. We aimed to improve the proportion of female adolescent ED patients who are notified of positive STI tests (gonorrhoea, Chlamydia, or trichomoniasis) using mobile phone calls and texting.
Methods A randomised intervention among 14–21 year-old females using a 2X3 factorial design with replication to improve patient notification, defined as the proportion of STI-positive females notified within 7 days of STI testing. We evaluated six combinations of two factors: (1) method of notification (call, text message, or call + text message) and (2) provision of an STI information card with or without an ED phone number to obtain test results. Covariates for logistic regression included age, empiric STI treatment, days until first contact and documentation of a confidential/mobile phone number.
Results Of 386 patients, 51% were 18–21 years, 35% were 16–17 years and 14% were 14–15 years old. Successful notification was significantly greater for call + text message vs. call only (Odds Ratio [OR] 3.1, 95% confidence interval [CI] 1.4 – 6.7). There was no significant interaction between card and method of notification. Texting only or type of STI information card was not significantly associated with patient notification. Documenting a confidential phone number was independently associated with successful notification (OR 3.3, 95% CI: 1.6–6.9). In total, 94% of those with a documented confidential phone number who received call + text message were notified of their positive STI results within 7 days of their ED visit.
Conclusions A combination of call + text messaging improved our ability to successfully notify adolescent women of their positive STI results after an ED visit. Documentation of a confidential phone number is also an important strategy to notify adolescent women of their STI results.
- emergency department
- quality improvement