Article Text
Abstract
Background Chlamydia reinfection increases the risk of pelvic inflammatory disease. Reinfection is common in Australia and while clinical guidelines recommend retesting 3 months post-treatment, less than 25% are retested. We aimed to examine general practitioner (GP) and patient views on retesting for chlamydia and recall/reminder systems to facilitate retesting.
Methods As part of a trial of chlamydia testing in general practice, GPs were provided with resources and support to implement recall/reminder systems to increase retesting. GPs’ attitudes and practices were examined pre- and mid-intervention using semi-structured interviews. Semi-structured interviews were also conducted with patients throughout the trial. Data were analysed thematically.
Results 44 GPs undertook a pre-intervention and 24 a mid-intervention interview; 22 patients were interviewed. GPs viewed recalls/reminders as essential to a formal chlamydia control program. There was disparity in whether systems to enable retesting were adopted during the intervention. Barriers to implementing these systems included concerns about costs and time required to ‘chase up’ patients; these barriers persisted during the intervention. Concerns about privacy were raised by most GPs but not patients. Over half of patients were not provided with advice about retesting at the time of their initial chlamydia test. Of the four patients who tested positive, two were retested as per guidelines. Patients were universally supportive of receiving reminders for chlamydia retesting, though retesting when at the clinic for another reason was viewed as ‘more practical’. Patients did not have strong preferences about reminder type (letter, SMS, email). Knowledge gaps were identified by both GPs and patients, and GPs identified a need to improve knowledge of the risks of chlamydia reinfection.
Conclusion GPs raised more concerns about retesting and reminders than patients. Increasing GP and patient knowledge of the risks of reinfection is crucial. GPs require additional support to implement strategies to increase re-testing.
Disclosure No significant relationships.