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O14.1 Is an automated online clinical care pathway for people with genital chlamydia (chlamydia-occp) within an esexual health clinic feasible and acceptable? proof of concept study
  1. CS Estcourt1,
  2. J Gibbs1,
  3. LJ Sutcliffe1,
  4. V Gkatzidou2,
  5. L Tickle1,
  6. K Hone2,
  7. C Aicken3,
  8. C Lowndes4,
  9. E Harding-Esch4,
  10. S Eaton5,
  11. P Oakeshott6,
  12. A Szczepura5,
  13. R Ashcroft1,
  14. G Hogan7,
  15. A Nettleship8,
  16. D Pinson9,
  17. ST Sadiq6,
  18. P Sonnenberg3
  1. 1Queen Mary University of London
  2. 2Brunel University London
  3. 3University College London
  4. 4Public Health UK
  5. 5Warwick University
  6. 6St George’s University of London
  7. 7The Doctors Laboratory
  8. 8epiGenesys
  9. 9The Royal Borough of Greenwich

Abstract

Introduction UK health strategy supports self- and internet-based care. Within the eSTI2 consortium (www.esti2.org.uk) we developed UK’s first automated Online Clinical Care Pathway for people with genital chlamydia (Chlamydia-OCCP) within an eSexual Health Clinic (eSHC). Chlamydia-OCCP includes: STI results service; clinical consultation; electronic prescription via community pharmacy; partner notification (PN); with integral telephone helpline support. It complies with regulatory, professional, prescribing and surveillance requirements. We report on a study to assess Chlamydia-OCCP feasibility and acceptability as an alternative to routine care.

Methods Non-randomised, exploratory study to evaluate Chlamydia-OCCP: 21.07.14 -13.03.15.

Participants: 1) chlamydia-positive untreated Genitourinary Medicine (GUM) clinic attenders; 2) people testing chlamydia-positive and negative through six National Chlamydia Screening Programme (NCSP) areas’ online postal self-sampling service. Exclusions: under 16 yrs; co-existing STIs, extra-genital chlamydia. Intervention: eligible people were sent an SMS message with a link to access results from eSHC via a password protected web-app, optimised for smartphone use. Having consented online chlamydia-positive users followed the automated Chlamydia-OCCP. Patients who declined received routine care.

Evaluation: treatment rate; time to treatment; PN outcomes; engagement with clinical helpline and health promotion; safety; acceptability, costs.

Results GUM: of 197 eligible patients, 161 accessed results online, 112 consented, 110/112 (98%) treated (72 exclusively via Chlamydia-OCCP, median 1 day). NCSP: of 145 eligible patients, 133 accessed results online, 104 consented, 92/104 (88%) treated (59 exclusively via Chlamydia-OCCP, median 1 day).

28/515 sexual partners were managed solely online. 1176/1936, (61%) NCSP chlamydia-negative people accessed results online, of whom 407 accessed online health promotion. All patients who didn’t access results online were managed routinely. Patients moved effectively between online, telephone and clinic-based care.

Conclusion Chlamydia-OCCP is a feasible, acceptable, safe alternative to routine care for management of people with genital chlamydia. Preliminary evidence indicates comparable treatment outcomes. If linked to home testing, Chlamydia-OCCP offers potential for wholly remote care.

Disclosure of interest statement Nothing to declare.

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