Research output per year
Research output per year
Abstract
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.
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.
| Original language | English |
|---|---|
| Pages (from-to) | e064664 |
| Journal | BMJ Open |
| Volume | 13 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 11 Jan 2023 |
Bibliographical note
Publisher Copyright:© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.
Research Groups and Themes
- HEHP@Bristol
Keywords
- Sexual health
- Chlamydia
- Gonorrhoea
- Rapid STI testing
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What can be learnt from a qualitative evaluation of implementing a rapid sexual health testing, diagnosis and treatment service?
Lorenc, A., Kesten, J., Brangan, E., Horner, P. J., Clarke, M., Crofts, M., Turner, J., Muir, P. & Horwood, J., 22 Oct 2021, In: BMJ Open. 11, 10, 12 p., e050109.Research output: Contribution to journal › Article (Academic Journal) › peer-review
Open AccessFile4 Citations (Scopus)74 Downloads (Pure) -
Unity Sexual Health rapid testing, diagnostic and treatment service evaluation: study protocol
Walter, S. R., Macleod, J. A. A., Horner, P. J., Hollingworth, W., Redaniel, M. T., Jackson, J., Lorenc, A., Kesten, J., Brangan, E., Mohiuddin, S. G., Crofts, M., Muir, P., Steer, J., Turner, J., Phillips, D., Wheeler, H., Clarke, M., Hartman, C. & Holly, J., 17 Jan 2020, (Unpublished) 36 p. NHS National Institute for Health Research.Research output: Other contribution
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