Background
Methods
Qualitative – semi-structured interviews
Quantitative – postal questionnaire
Ethics
Results
GPs' attitudes to screening
Qualitative component
Quantitative component
Statement | % (95%CI) |
---|---|
An opportunistic screening program capturing eligible people when they present to a GP for any reason. | 25 (20, 31) |
An opportunistic screening program capturing eligible people when they present to a GP for a sexual health reason (e.g.: Pap smear, contraception advice). | 36 (30, 42) |
An organised screening program similar to the Pap smear or breast-screening program with a system of invitation, recall and reminders. | 38 (32, 44) |
There is no need for a chlamydia screening program in Australia | 1 (0, 3) |
Barriers and facilitators of screening for chlamydia
Qualitative component
a) Barriers
General practitioners are under the pump at the moment time wise, we have very little time. And that's not going to change. (DC07)
b) Facilitators
Quantitative component
a) Barriers
Barrier | Probably not % (95%CI) | Not sure % (95%CI) | Probably % (95%CI) |
---|---|---|---|
Concerns about over-serving | 74 (68, 80) | 6 (3, 9) | 20 (15, 25) |
The cost of testing to the client | 72 (70, 77) | 7 (4, 10) | 21 (16, 30) |
Time constraints during the consultation | 32 (26, 38) | 6 (3, 9) | 62 (56, 68) |
Difficulty in talking with patients about sexual health issues | 74 (68, 79) | 8 (5, 12) | 18 (13, 23) |
The chance of getting a false positive result on testing | 73 (67, 78) | 16 (12, 21) | 10 (7, 15) |
Concerns that some pathology providers prefer swabs rather than urine specimens for chlamydia testing | 67 (61, 73) | 16 (12, 21) | 17 (12, 22) |
Patient's lack of knowledge about chlamydia | 58 (51, 64) | 9 (6, 13) | 33 (27, 39) |
Religion or ethnicity of patient | 50 (43, 56) | 19 (14, 24) | 31 (25, 37) |
Lack of a formal recall/reminder system for chlamydia testing | 40 (34, 46) | 19 (14, 24) | 41 (35, 47) |
Lack of support for partner notification/following up of the partners of positive cases | 39 (33, 46) | 22 (17, 28) | 39 (33, 35) |
Facilitators | |||
If there was a recognised national chlamydia screening program | 4 (2, 7) | 3 (1, 6) | 93 (89, 96) |
If payment was available for a practice nurse to discuss chlamydia testing with patients and conduct the testing | 21 (16, 27) | 9 (6, 13) | 70 (63, 75) |
If there were national guidelines recommending who should be screened and tested for chlamydia | 3 (1, 6) | 5 (3, 9) | 92 (87, 94) |
If there was an incentive payment to GPs for each chlamydia testing performed | 9 (6, 13) | 7 (4, 11) | 83 (78, 88) |
If GPs had more knowledge on how to manage chlamydia infected patients | 36 (30, 43) | 13 (9, 18) | 50 (43, 56) |
If there was an organised chlamydia education program for the general public | 4 (2, 8) | 5 (3, 9) | 90 (85, 93) |
If there was a recall/reminder system | 10 (6, 14) | 13 (9, 17) | 77 (71, 82) |
b) Facilitators
Partner notification
Qualitative component
Quantitative component
Partner notification practices | Proportion* % (95%CI) |
---|---|
Ask the patient to follow up their contacts | 92 (88, 95) |
Give the patient a contact letter to give to their contacts | 23 (18, 292) |
Write a letter to the patient's contacts directly | 2 (0.4, 4) |
Directly ask the health department partner notification officers to follow up their contacts | 14 (10, 19) |
Nothing – the health department does the partner notification whenever a new case of chlamydia is notified | 8 (5, 12) |
Partner notification resources | |
Partner/contact letters | 70 (64, 75) |
Websites | 42 (36, 48) |
SMS phone messages | 7 (4, 10) |
Telephone hotline | 31 (25, 37) |
Health department partner notification officers | 50 (44, 56) |