Partner Notification for Chlamydia in Primary Care

Study Overview
=================
Brief Summary
-----------------
The purpose of this study was to compare the effectiveness of partner notification by general practice nurses with referral to a specialist clinic for people with genital chlamydia diagnosed in a community setting. We hypothesised that referral to a specialist would be more effective in ensuring treatment of the sexual partners of infected people than the simpler nurse-led strategy.

Detailed Description
-----------------
Partner notification (contact tracing) is essential to the control of sexually transmitted infections. Reports of new chlamydia infections have increased by 66% in the past five years. A National Chlamydia Screening Programme in England, and increasing primary care provision of sexual health care are part of the United Kingdom Government's strategy for tackling increasing rates of sexually transmitted infections. New strategies for managing chlamydia in non-specialist settings are urgently required: genitourinary medicine clinics are failing to cope with their increasing workload; and 45% of cases detected in the chlamydia screening pilot studies were diagnosed in general practice. Partner notification involves informing the sexual partners of someone with a sexually transmitted infection of the possibility of exposure, offering them diagnosis and treatment, and providing advice about preventing future infection. In the United Kingdom, this is usually done by specialist sexual health advisers in departments of genitourinary medicine. The effectiveness of partner notification in non-specialist settings in developed countries is not known. We conducted a randomised controlled trial to compare the effectiveness of practice nurse-led partner notification with referral to a genitourinary clinic for partner notification conducted by a specialist health adviser, and to compare the resources used by each strategy. Comparisons: Partner notification at the time of receiving diagnosis and treatment by general practice nurses who received a one-day training course and ongoing support by telephone calls or visits from a specialist adviser in sexual health, compared with referral to a genitourinary medicine clinic for partner notification by a specialist adviser in sexual health.

Official Title
-----------------
Partner Notification for Chlamydia in Primary Care: Randomised Controlled Trial and Economic Evaluation

Conditions
-----------------
Chlamydia Infections

Intervention / Treatment
-----------------
* Behavioral: Practice nurse-led partner notification
* Behavioral: Referral to specialist genitourinary clinic


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Chlamydia trachomatis diagnosed through a population-based screening study Chlamydia test result received at patient's general practice Chlamydia cases diagnosed in general practice Exclusion Criteria: None

Ages Eligible for Study
-----------------
Minimum Age: 16 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Intervention/Treatment |
| --- |
|Behavioral: Practice nurse-led partner notification|nan|
|Behavioral: Referral to specialist genitourinary clinic|nan|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of index cases with at least one sexual partner treated |  |  | 
| Number of sexual partners per index case treated |  |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of sexual partners per index case elicited during sexual history taking |  |  | 
| Positive chlamydia test result six weeks after treatment |  |  | 
| Adherence to advice to abstain from sexual intercourse until both partners completed treatment |  |  | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Chlamydia trachomatis, Chlamydia infections, Randomized controlled trials, Contact tracing, Family practice