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Impact of rapid near-patient STI testing on service delivery outcomes in an integrated sexual health service in the United Kingdom:a controlled interrupted time series study

Title: Impact of rapid near-patient STI testing on service delivery outcomes in an integrated sexual health service in the United Kingdom:a controlled interrupted time series study
Authors: Walter, Scott R; Jackson, Joni; Myring, Gareth; Redaniel, Maria Theresa; Margelyte, Ruta; Gardiner, Rebecca; Clarke, Michael; Crofts, Megan; McLeod, Hugh S T; Hollingworth, William; Phillips, David; Muir, Peter; Steer, Jonathan; Turner, Jonathan; Horner, Paddy J; de Vocht , Frank
Source: Walter, S R, Jackson, J, Myring, G, Redaniel, M T, Margelyte, R, Gardiner, R, Clarke, M, Crofts, M, McLeod, H S T, Hollingworth, W, Phillips, D, Muir, P, Steer, J, Turner, J, Horner, P J & de Vocht , F 2023, 'Impact of rapid near-patient STI testing on service delivery outcomes in an integrated sexual health service in the United Kingdom : a controlled interrupted time series study', BMJ Open, vol. 13, no. 1, pp. e064664. https://doi.org/10.1136/bmjopen-2022-064664
Publication Year: 2023
Collection: University of Bristol: Bristol Reserach
Subject Terms: /dk/atira/pure/core/keywords/fohsheb; name=HEHP@Bristol; Sexual health; Chlamydia; Gonorrhoea; Rapid STI testing
Description: Objectives To evaluate the impact of a new clinic-based rapid sexually transmitted infection testing, diagnosis and treatment service on healthcare delivery and resource needs in an integrated sexual health service. Design Controlled interrupted time series study. Setting Two integrated sexual health services (SHS) in UK: Unity Sexual Health in Bristol, UK (intervention site) and Croydon Sexual Health in London (control site). Participants Electronic patient records for all 58 418 attendances during the period 1 year before and 1 year after the intervention. Intervention Introduction of an in-clinic rapid testing system for gonorrhoea and chlamydia in combination with revised treatment pathways. Outcome measures Time-to-test notification, staff capacity, cost per episode of care and overall service costs. We also assessed rates of gonorrhoea culture swabs, follow-up attendances and examinations. Results Time-to-notification and the rate of gonorrhoea swabs significantly decreased following implementation of the new system. There was no evidence of change in follow-up visits or examination rates for patients seen in clinic related to the new system. Staff capacity in clinics appeared to be maintained across the study period. Overall, the number of episodes per week was unchanged in the intervention site, and the mean cost per episode decreased by 7.5% (95% CI 5.7% to 9.3%). Conclusions The clear improvement in time-to-notification, while maintaining activity at a lower overall cost, suggests that the implementation of clinic-based testing had the intended impact, which bolsters the case for more widespread rollout in sexual health services.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/36631238; info:eu-repo/semantics/altIdentifier/hdl/https://hdl.handle.net/1983/043bfb60-6e9c-4b23-a869-f2adb67bef23; info:eu-repo/semantics/reference/pmid/34686552; info:eu-repo/semantics/reference/hdl/https://hdl.handle.net/1983/1b3aec3f-d619-44cc-aaab-1d7554ee5b05; info:eu-repo/semantics/reference/hdl/https://hdl.handle.net/1983/79f8f4a6-6710-42e3-b1fd-4fc836ea7618
DOI: 10.1136/bmjopen-2022-064664
Availability: https://hdl.handle.net/1983/043bfb60-6e9c-4b23-a869-f2adb67bef23; https://research-information.bris.ac.uk/en/publications/043bfb60-6e9c-4b23-a869-f2adb67bef23; https://doi.org/10.1136/bmjopen-2022-064664; https://research-information.bris.ac.uk/ws/files/352666960/e064664.full.pdf
Rights: info:eu-repo/semantics/openAccess ; http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.18A09BFA
Database: BASE