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SMS reminders improve re-screening in women and heterosexual men with chlamydia infection at Sydney Sexual Health Centre: a before-and-after study
  1. Rebecca Guy1,
  2. Handan Wand1,
  3. Vickie Knight2,
  4. Aurelie Kenigsberg2,
  5. Phillip Read2,
  6. Anna M McNulty2,3
  1. 1The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
  2. 2Sydney Sexual Health Centre, Sydney, New South Wales, Australia
  3. 3School of Public Health and Community Medicine, University of New South Wales, Kensington, New South Wales, Australia
  1. Correspondence to Dr Rebecca Guy, The Kirby Institute, University of New South Wales, Cliffbrook Campus, 45 Beach Street, Coogee NSW 2031, Australia; rguy{at}kirby.unsw.edu.au

Abstract

Background In 2009, Sydney Sexual Health Centre implemented a short message service (SMS) reminder system to improve re-screening after chlamydia infection. SMS reminders were sent at 3 months recommending the patient make an appointment for a re-screen.

Methods Using a before-and-after study, the authors compared the proportion re-screened within 1–4 months of chlamydia infection in women and heterosexual men who were sent an SMS in January to December 2009 (intervention period) with a 18-month period before the SMS was introduced (before period). The authors used a χ2 test and multivariate regression. Visitors and sex workers were excluded.

Results In the intervention period, 141 of 343 (41%) patients were diagnosed with chlamydia and sent the SMS reminder. In the before period, 338 patients were diagnosed as having chlamydia and none received a reminder. The following baseline characteristics were significantly different between those sent the SMS in the intervention period and the before period: new patients (82% vs 72%, p=0.02), aged <25 years (51% vs 33% p<0.01), three or more sexual partners in the last 3 months (31% vs 27%, p<0.01) and anogenital symptoms (52% vs 38%, p<0.01). The proportion re-screened 1–4 months after chlamydia infection was significantly higher in people sent the SMS (30%) than the before period (21%), p=0.04, and after adjusting for baseline differences, the OR was 1.57 (95% CI 1.01 to 2.46).

Conclusions SMS reminders increased re-screening in patients diagnosed as having chlamydia at a sexual health clinic. The clinic now plans to introduce electronic prompts to maximise the uptake of the initiative and consider strategies to further increase re-screening.

  • Chlamydia
  • reminder systems
  • intervention studies
  • epidemiology (clinical)
  • epidemiology (general)
  • bacterial infection
  • prevention
  • primary care
  • behavioural science
  • biostatistics
  • HIV
  • users perspective
  • testing
  • surveillance
  • sexual health
  • service delivery
  • gonorrhoea
  • chlamydia trachomatis
  • syphilis
  • STD surveillance
  • STD
  • STD patients
  • STD clinic
  • STD services
  • STDS
  • STD control

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Footnotes

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the South Eastern Sydney Area Health Service research ethics committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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