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

Scott R Walter*, Joni Jackson, Gareth Myring, Maria Theresa Redaniel, Ruta Margelyte, Rebecca Gardiner, Michael Clarke, Megan Crofts, Hugh S T McLeod, William Hollingworth, David Phillips, Peter Muir, Jonathan Steer, Jonathan Turner, Paddy J Horner, Frank de Vocht

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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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.
Original languageEnglish
Pages (from-to)e064664
JournalBMJ Open
Volume13
Issue number1
DOIs
Publication statusPublished - 11 Jan 2023

Bibliographical note

Publisher Copyright:
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.

Structured keywords

  • HEHP@Bristol

Keywords

  • Sexual health
  • Chlamydia
  • Gonorrhoea
  • Rapid STI testing

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