Partner notification of chlamydia infection in primary care: randomised controlled trial and analysis of resource use

BMJ. 2006 Jan 7;332(7532):14-9. doi: 10.1136/bmj.38678.405370.7C. Epub 2005 Dec 15.

Abstract

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.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Chlamydia Infections / epidemiology
  • Chlamydia Infections / nursing
  • Chlamydia Infections / prevention & control*
  • Contact Tracing / economics
  • Contact Tracing / methods*
  • Costs and Cost Analysis
  • England / epidemiology
  • Family Practice / economics
  • Family Practice / statistics & numerical data
  • Female
  • Health Resources / statistics & numerical data
  • Humans
  • Male
  • Nurse Practitioners / standards
  • Nurse Practitioners / statistics & numerical data*
  • Referral and Consultation / statistics & numerical data
  • Specimen Handling / economics
  • Specimen Handling / statistics & numerical data

Associated data

  • ClinicalTrials.gov/NCT00112255