Chlamydia screening in community pharmacies: a systematic literature review of the characteristics of service users and a meta-analysis of chlamydia prevalence
Mufiza Zia KapadiaCentre for Population Health Sciences, University of Edinburgh, Medical School, Teviot Place, EH8 9AG, Edinburgh, United Kingdom. Email: mufiza.farid@gmail.com
Sexual Health 10(1) 1-8 https://doi.org/10.1071/SH11191
Submitted: 4 January 2012 Accepted: 1 June 2012 Published: 21 December 2012
Abstract
A systematic review was undertaken to estimate the prevalence of chlamydia (Chlamydia trachomatis) infection among those screened in community pharmacies. The uptake of screening and clients’ sociodemographic and behavioural characteristics were also reviewed. Eleven papers contributed to the final review. The proportional meta-analysis showed a chlamydia positivity of 8.1% (95% confidence interval: 7.3%–8.9%). Chlamydia screening programs in community pharmacies tended to be targeted at certain client groups such as those seeking emergency contraception in pharmacies. The pharmacists were reluctant to offer chlamydia screening to potential clients. The uptake of the service was much lower, and tended not to include men and ethnic minorities.
Additional keywords: sexually transmissible infection.
References
[1] Guy RJ, Kong F, Goller J, Franklin N, Bergeri I, Dimech W, et al A new national chlamydia sentinel surveillance system in Australia: evaluation of the first stage of implementation. CDI 2010; 34 319–28.[2] European Centre for Disease Prevention and Control (ECDC). Sexually transmitted infections in Europe, 1990–2009. Stockholm: ECDC; 2011.
[3] Weinstock H, Berman S, Cates W. Sexually transmitted diseases among American youth: incidence and prevalence estimates, 2000. Perspect Sex Reprod Health 2004; 36 6–10.
| Sexually transmitted diseases among American youth: incidence and prevalence estimates, 2000.Crossref | GoogleScholarGoogle Scholar |
[4] Adams EJ, Charlett A, Edmunds WJ, Hughes G. Chlamydia trachomatis in the United Kingdom: a systematic review and analysis of prevalence studies. Sex Transm Infect 2004; 80 354–62.
| Chlamydia trachomatis in the United Kingdom: a systematic review and analysis of prevalence studies.Crossref | GoogleScholarGoogle Scholar |
[5] Fenton K. Screening men for Chlamydia trachomatis infection: have we fully explored the possibilities? Commun Dis Public Health 2000; 3 86–9.
[6] Heijne JCM, Althaus CL, Herzog SA, Kretzschmar M, Low N. The role of reinfection and partner notification in the efficacy of chlamydia screening programs. J Infect Dis 2011; 203 372–7.
| The role of reinfection and partner notification in the efficacy of chlamydia screening programs.Crossref | GoogleScholarGoogle Scholar |
[7] Golden MR, Whittington WL, Handsfield HH, Hughes JP, Stamm WE, Hogben M, et al Effect of expedited treatment of sex partners on recurrent or persistent gonorrhea or chlamydial infection. N Engl J Med 2005; 352 676–85.
| Effect of expedited treatment of sex partners on recurrent or persistent gonorrhea or chlamydial infection.Crossref | GoogleScholarGoogle Scholar |
[8] Scottish Intercollegiate Network (SIGN). Management of genital Chlamydia trachomatis infection: a national clinical guideline. Edinburgh: NHS Quality Improvement; 2009.
[9] Low N, Egger M, Sterne JA, Harbord RM, Ibrahim F, Lindblom B, et al Incidence of severe reproductive tract complications associated with diagnosed genital chlamydial infection: the Uppsala Women’s Cohort Study. Sex Transm Infect 2006; 82 212–8.
| Incidence of severe reproductive tract complications associated with diagnosed genital chlamydial infection: the Uppsala Women’s Cohort Study.Crossref | GoogleScholarGoogle Scholar |
[10] Adams EJ, Turner KM, Edmunds WJ. The cost effectiveness of opportunistic chlamydia screening in England. Sex Transm Infect 2007; 83 267–74.
| The cost effectiveness of opportunistic chlamydia screening in England.Crossref | GoogleScholarGoogle Scholar |
[11] Gaydos CA, Barnes M, Aumakhan B, Quinn N, Wright C, Agreda P, et al Chlamydia trachomatis age-specific prevalence in women who used an internet-based self-screening program compared to women who were screened in family planning clinics. Sex Transm Dis 2011; 38 74–78.
| Chlamydia trachomatis age-specific prevalence in women who used an internet-based self-screening program compared to women who were screened in family planning clinics.Crossref | GoogleScholarGoogle Scholar |
[12] Gotz HM, Veldhuijzen IK, van Bergen JEAM, Hoebe CJPA, de Zwart O, Richardus JH, et al Acceptability and consequences of screening for Chlamydia trachomatis by home-based urine testing. Sex Transm Dis 2005; 32 557–62.
| Acceptability and consequences of screening for Chlamydia trachomatis by home-based urine testing.Crossref | GoogleScholarGoogle Scholar |
[13] Roberts TE, Robinson S, Barton PM, Bryan S, McCarthy A, Macleod J, et al Cost effectiveness of home based population screening for Chlamydia trachomatis in the UK: economic evaluation of chlamydia screening studies (ClaSS) project. BMJ 2007; 335 291–4.
| Cost effectiveness of home based population screening for Chlamydia trachomatis in the UK: economic evaluation of chlamydia screening studies (ClaSS) project.Crossref | GoogleScholarGoogle Scholar |
[14] Sacks-Davis R, Gold J, Aitken C, Hellard M. Home-based chlamydia testing of young people attending a music festival – who will pee and post? BMC Public Health 2010; 10 376–84.
| Home-based chlamydia testing of young people attending a music festival – who will pee and post?Crossref | GoogleScholarGoogle Scholar |
[15] Hocking JS, Parker RM, Pavlin N, Fairley CK, Gunn JM. What needs to change to increase chlamydia screening in general practice in Australia? The views of general practitioners. BMC Public Health 2008; 8 425–32.
| What needs to change to increase chlamydia screening in general practice in Australia? The views of general practitioners.Crossref | GoogleScholarGoogle Scholar |
[16] McNulty CAM, Freeman E, Howell-Jones R, Hogan A, Randall S, Ford-Young W, et al Overcoming the barriers to chlamydia screening in general practice: a qualitative study. Family Practice 2010 June 1 2010; 27 291–302.
| Overcoming the barriers to chlamydia screening in general practice: a qualitative study.Crossref | GoogleScholarGoogle Scholar |
[17] Noyce PR. Providing patient care through community pharmacies in the UK: policy, practice, and research. Ann Pharmacother 2007; 41 861–8.
| Providing patient care through community pharmacies in the UK: policy, practice, and research.Crossref | GoogleScholarGoogle Scholar |
[18] Odedina FT, Hepler CD, Segal R, Miller D. The Pharmacists’ Implementation of Pharmaceutical Care (PIPC) model. Pharm Res 1997; 14 135–44.
| The Pharmacists’ Implementation of Pharmaceutical Care (PIPC) model.Crossref | GoogleScholarGoogle Scholar |
[19] Bissell P, Anderson C. Supplying emergency contraception via community pharmacies in the UK: reflections on the experiences of users and providers. Soc Sci Med 2003; 57 2367–78.
| Supplying emergency contraception via community pharmacies in the UK: reflections on the experiences of users and providers.Crossref | GoogleScholarGoogle Scholar |
[20] Dabrera G, Pinson D, Whiteman S. Chlamydia screening by community pharmacists: a qualitative study. J Fam Plann Reprod Health Care 2011; 37 17–21.
| Chlamydia screening by community pharmacists: a qualitative study.Crossref | GoogleScholarGoogle Scholar |
[21] Thomas G, Humphris G, Ozakinci G, O’Brien K, Roberts SA, Hopkins M, et al A qualitative study of pharmacists’ views on offering chlamydia screening to women requesting emergency hormonal contraception. BJOG 2010; 117 109–13.
| A qualitative study of pharmacists’ views on offering chlamydia screening to women requesting emergency hormonal contraception.Crossref | GoogleScholarGoogle Scholar |
[22] TNS Healthcare. Pharmacy chlamydia screening Pathfinder evaluation (PCSPf). London: The Department of Health; 2007.
[23] QSR International. NVivo qualitative data analysis software. 8 ed. Melbourne: QSR International; 2008.
[24] Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol 2008; 8 45–54.
| Methods for the thematic synthesis of qualitative research in systematic reviews.Crossref | GoogleScholarGoogle Scholar |
[25] Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003 September 6 2003; 327 557–60.
[26] Anderson C, Thornley T. A pharmacy-based private chlamydia screening programme: results from the first 2 years of screening and treatment. Int J Clin Pharmacol 2011; 33 88–91.
| A pharmacy-based private chlamydia screening programme: results from the first 2 years of screening and treatment.Crossref | GoogleScholarGoogle Scholar |
[27] Brabin L, Thomas G, Hopkins M, O’Brien K, Roberts SA. Delivery of chlamydia screening to young women requesting emergency hormonal contraception at pharmacies in Manchester, UK: a prospective study. BMC Womens Health 2009; 9 7–13.
| Delivery of chlamydia screening to young women requesting emergency hormonal contraception at pharmacies in Manchester, UK: a prospective study.Crossref | GoogleScholarGoogle Scholar |
[28] Gudka S, Marshall L, Creagh A, Clifford R. To develop and pilot a best practice community pharmacy chlamydia screening mode. Perth: University of Western Australia; 2010.
[29] van Bergen JE, Postma MJ, Peerbooms PG, Spangenberg AC, Tjen ATJ, Bindels PJ. Effectiveness and cost-effectiveness of a pharmacy-based screening programme for Chlamydia trachomatis in a high-risk health centre population in Amsterdam using mailed home-collected urine samples. Int J STD AIDS 2004; 15 797–802.
| Effectiveness and cost-effectiveness of a pharmacy-based screening programme for Chlamydia trachomatis in a high-risk health centre population in Amsterdam using mailed home-collected urine samples.Crossref | GoogleScholarGoogle Scholar |
[30] Baraitser P, Pearce V, Holmes J, Horne N, Boynton PM. Chlamydia testing in community pharmacies: evaluation of a feasibility pilot in south east London. Qual Saf Health Care 2007; 16 303–7.
| Chlamydia testing in community pharmacies: evaluation of a feasibility pilot in south east London.Crossref | GoogleScholarGoogle Scholar |
[31] Watson MC. Final report: chlamydia testing in community and primary care settings. Aberdeen: University of Aberdeen; 2008.
[32] Emmerton L, Skinner MB, Gardiner E. Nissen L, Debattista J. A trial of the distribution of chlamydia self-collection postal specimen kits from Australian community pharmacies. Sex Health 2011; 8 130–2.
| Nissen L, Debattista J. A trial of the distribution of chlamydia self-collection postal specimen kits from Australian community pharmacies.Crossref | GoogleScholarGoogle Scholar |
[33] Muir A. Pilot of chlamydia testing and treatment in community pharmacies. 2008.
[34] Bloomfield PJ, Kent C, Campbell D, Hanbrook L, Klausner JD. Community-based chlamydia and gonorrhea screening through the United States mail, San Francisco. Sex Transm Dis 2002; 29 294–7.
| Community-based chlamydia and gonorrhea screening through the United States mail, San Francisco.Crossref | GoogleScholarGoogle Scholar |
[35] Anthony GB, Watson MC. Chlamydia testing in community and primary care settings: a qualitative evaluation. Aberdeen: University of Aberdeen; 2008.
[36] Marrazzo JM, Scholes D. Acceptability of urine-based screening for Chlamydia trachomatis in asymptomatic young men: a systematic review. Sex Transm Dis 2008; 35 S28–33.
| Acceptability of urine-based screening for Chlamydia trachomatis in asymptomatic young men: a systematic review.Crossref | GoogleScholarGoogle Scholar |
[37] Heritage J, Jones M. A study of young peoples’ attitudes to opportunistic chlamydia testing in UK general practice. Reprod Health 2008; 5 11–20.
| A study of young peoples’ attitudes to opportunistic chlamydia testing in UK general practice.Crossref | GoogleScholarGoogle Scholar |
[38] Pavlin NL, Gunn JM, Parker R, Fairley CK, Hocking J. Implementing chlamydia screening: what do women think? A systematic review of the literature. BMC Public Health 2006; 6 221–32.
| Implementing chlamydia screening: what do women think? A systematic review of the literature.Crossref | GoogleScholarGoogle Scholar |
[39] Pavlin N, Parker R, Fairley C, Gunn J, Hocking J. Take the sex out of STI screening! Views of young women on implementing chlamydia screening in general practice. BMC Infect Dis 2008; 8 62–6.
| Take the sex out of STI screening! Views of young women on implementing chlamydia screening in general practice.Crossref | GoogleScholarGoogle Scholar |
[40] Balfe M, Brugha R, O’Donovan D, O’Connell E, Vaughan D. Young women’s decisions to accept chlamydia screening: influences of stigma and doctor–patient interactions. BMC Public Health 2010; 10 425–36.
| Young women’s decisions to accept chlamydia screening: influences of stigma and doctor–patient interactions.Crossref | GoogleScholarGoogle Scholar |
[41] Hogan A, Howell-Jones R, Pottinger E, Wallace L, McNulty C. “They should be offering it”: a qualitative study to investigate young peoples’ attitudes towards chlamydia screening in GP surgeries. BMC Public Health 2010; 10 616–24.
| “They should be offering it”: a qualitative study to investigate young peoples’ attitudes towards chlamydia screening in GP surgeries.Crossref | GoogleScholarGoogle Scholar |
[42] Kapadia MZ, Warner P, Fairhurst K, Muir A, Glasier A. Assessment of pharmacy staff competence and training needs to deliver chlamydia screening in community pharmacies. Journal of Pharmaceutical Health Service Research 2012.
[43] Low N, Broutet N, Adu-Sarkodie Y, Barton P, Hossain M, Hawkes S. Global control of sexually transmitted infections. Lancet 2006; 368 2001–16.
| Global control of sexually transmitted infections.Crossref | GoogleScholarGoogle Scholar |
[44] Freeman E, Howell-Jones R, Oliver I, Randall S, Ford-Young W, Beckwith P, et al Promoting chlamydia screening with posters and leaflets in general practice – a qualitative study. BMC Public Health 2009; 9 383–91.
| Promoting chlamydia screening with posters and leaflets in general practice – a qualitative study.Crossref | GoogleScholarGoogle Scholar |
[45] Egger M, Schneider M, Smith GD. Meta-analysis Spurious precision? Meta-analysis of observational studies. BMJ 1998 January 10 1998; 316 140–4.
| Meta-analysis Spurious precision? Meta-analysis of observational studies.Crossref | GoogleScholarGoogle Scholar |
[46] Hopewell S, McDonald S, Clarke M, Egger M. Grey literature in meta-analyses of randomized trials of health care interventions. Cochrane Database Syst Rev 2007; 2
| Grey literature in meta-analyses of randomized trials of health care interventions.Crossref | GoogleScholarGoogle Scholar |
[47] Thornton A, Lee P. Publication bias in meta-analysis: its causes and consequences. J Clin Epidemiol 2000; 53 207–16.
| Publication bias in meta-analysis: its causes and consequences.Crossref | GoogleScholarGoogle Scholar |
[48] National Chlamydia Screening Programme (NCSP). NCSP five years: the fifth annual report of the National Chlamydia Screening Programme 2007/08. London: NCSP; 2008.