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Published on: October 23, 2013
Partner notification of chlamydia infection in primary care: randomised controlled trial and analysis of resource use
Nicola Low1, Anne McCarthy, Tracy E Roberts
1Department of Social Medicine, University of Bristol, Bristol BS8 2PR. low@ispm.unibe.ch
Objective:
To evaluate the effectiveness of a practice nurse led strategy to improve the notification and treatment of partners of people with chlamydia infection.
Design:
Randomised controlled trial.
Setting:
27 general practices in the Bristol and Birmingham areas.
Participants:
140 men and women with chlamydia (index cases) diagnosed by screening of a home collected urine sample or vulval swab specimen.
Interventions:
Partner notification at the general practice immediately after diagnosis by trained practice nurses, with telephone follow up by a health adviser; or referral to a specialist health adviser at a genitourinary medicine clinic.
Main Outcome Measures:
Primary outcome was the proportion of index cases with at least one treated sexual partner. Specified secondary outcomes included the number of sexual contacts elicited during a sexual history, positive test result for chlamydia six weeks after treatment, and the cost of each strategy in 2003 sterling prices.
Results:
65.3% (47/72) of participants receiving practice nurse led partner notification had at least one partner treated compared with 52.9% (39/68) of those referred to a genitourinary medicine clinic (risk difference 12.4%, 95% confidence interval -1.8% to 26.5%). Of 68 participants referred to the clinic, 21 (31%) did not attend. The costs per index case were 32.55 pounds sterling for the practice nurse led strategy and 32.62 pounds sterling for the specialist referral strategy.
Conclusion:
Practice based partner notification by trained nurses with telephone follow up by health advisers is at least as effective as referral to a specialist health adviser at a genitourinary medicine clinic, and costs the same. Trial registration Clinical trials: NCT00112255.
