GP Management of sexually-acquired Chlamydia infections in North Queensland Dr. Tracy Cheffins MBBS...
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Transcript of GP Management of sexually-acquired Chlamydia infections in North Queensland Dr. Tracy Cheffins MBBS...
GP Management of sexually-acquired Chlamydia infections
in North Queensland
Dr. Tracy Cheffins MBBS MPH FRACGP FAFPHM
Scottish School of Primary CareEdinburgh 2011
Townsville, Australia
The Problem
• Prevalence of Chlamydia increasing• Most research done in public clinics• Most treatment done by private GPs• Control requires treatment of partner contacts• Evidence of inconsistent GP management of
contact tracing
The Place
The Research Team
• Dr. Tracy Cheffins, NQPBRN*• Ms. Margaret Spillman, NQPBRN• A/Prof. Clare Heal, School of Medicine and Dentistry
(Mackay)• Dr. Monika Buhrer-Skinner, Qld Health sexual health unit• A/Prof. Sarah Larkins, School of Medicine and Dentistry• GPs and nurses, 9 General Practices in North Queensland
*(North Queensland Practice Based Research Network)
The Questions
• Do GPs manage Chlamydia according to Queensland Health sexual health guidelines?
• Why do GPs refer for Chlamydia testing?
• What do GPs tell their patients?
The Methods
• Practice nurse audit of 12 months of positive Chlamydia cases diagnosed by practice GPs (n=176)
• Three month collection of “reason for referral” data for all Chlamydia tests referred by practice GPs (n=521)
• GP questionnaire on usual management and preferred contact tracing methods (n=35)
The Workforce
Results (1) - Audit
N=176
Prescribed medication
Results (1) - Audit
Results of follow up Chlamydia tests
Results (2) - Referrals
N=521
Reasons for GP referral for Chlamydia test
Results (3) - GP surveyN=35
51%43%
6%
same or next day within 2-4 daysnext available appt
26%
40%
23%
11%
always sometimes seldom never
How often GPs treat patients with symptoms of Chlamydia prior to receiving test results
How quickly GPs ask to see patients after a positive test result
Results (3) - GP survey
Length of time GPs advised
patients to use condoms after treatment for
Chlamydia infection.
Results (3) - GP survey
Length of time to repeat test following
treatment of Chlamydia infection.
Preferred methods for contact tracing ranked from most to least
• Electronic contact methods• Printed resources• GP access to an external contact tracer• Direct register referral of ALL cases to contact tracer• GP referral of ALL cases to contact tracer
• Very little support for the status quo (<10%)
Tropical Cyclone Yasi
NQPBRN
• 15 practices have participated in research (approx 45 GPs)
• Academic coordinator (0.4 FTE)• Research worker (0.5 FTE)• Started 2007 with RACGP grant for road trauma research study• Funded by Australian Dept of Health and Ageing PHCRED*
capacity building grant since 2008• Five completed studies• Two studies for completion 2011
*(Primary Health Care Research Evaluation and Development program)
Completed Studies
• Rural GP management of chronic road crash trauma cases – GP survey
• GP management of acute otitis externa – audit, prospective data collection, GP survey
• Evaluation of over 75 years health assessments in General Practice – 2 projects - GP audit and patient survey
• Parent vaccination study – cross sectional patient survey with follow-up by practice nurses.
The Strategy
• Work with nurses rather than GPs• Pay practices for nurse research time• Provide research training for nurses• Visit practices (with food) to recruit GPs and share results• Ensure CPD points available for research• Support network members to attend conferences, write
papers• Gentle persuasion and personal touch