Chlamydia testing in general practice in Australia

Shailendra Sawleshwarkar; Christopher Harrison; Helena Britt; Adrian Mindel

doi:10.1071/SH09110

RESEARCH ARTICLE

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Chlamydia testing in general practice in Australia

Shailendra Sawleshwarkar ^A ^C , Christopher Harrison ^B , Helena Britt ^B and Adrian Mindel ^A

+ Author Affiliations

- Author Affiliations

^A Sexually Transmitted Infections Research Centre and University of Sydney, Marian Villa, Westmead Hospital, Westmead, NSW 2145, Australia.

^B Family Medicine Research Centre, Sydney School of Public Health, University of Sydney, NSW 2150, Australia.

^C Corresponding author. Email: s.sawleshwarkar@usyd.edu.au

Sexual Health 7(4) 484-490 https://doi.org/10.1071/SH09110
Submitted: 10 October 2009 Accepted: 28 January 2010 Published: 10 November 2010

Abstract

Objectives: We aimed to ascertain how frequently Australian general practitioners (GPs) test patients for chlamydia and to determine GP, patient and encounter characteristics where tests occurred. Methods: We identified all GP, patient and encounter characteristics associated with higher testing rates, April 2000 to March 2007, using the Bettering the Evaluation and Care of Health data. Multiple logistic regression was used to measure the effect of each GP, patient and encounter characteristic. Results: Data were available for 689 000 encounters from 6890 GPs, of which 2236 were test encounters. Testing rates increased significantly between 2000 and 2007 (P < 0.0001). The rate of testing was higher for female patients (4.2 per 1000, 95% confidence interval (CI): 3.8–4.5) than males (2.0; 95% CI: 1.8–2.2). Predictors of higher chlamydia testing were: female GP (adjusted odds ratio (AOR): 1.84; 95% CI: 1.60–2.1); GP age (<35 v. 55+, 2.17; 95% CI: 1.65–2.85); practice in a major city (1.34; 95% CI: 1.18–1.52); large practice (5+ GP practice v. solo, 1.69; 95% CI: 1.27–2.25); graduated in Australia (1.22; 95% CI: 1.04–1.44); patient sex and younger age, being new to the practice (1.65; 95% CI: 0.47–1.86), Indigenous (3.46; 95% CI: 2.64–4.54), late in the study (twice as likely in 2006–07 than in 2000–01) and ‘opportunity to test’ (AOR: 32.25; 95% CI: 27.25–38.16). Conclusions: Chlamydia testing rates have increased in general practice in Australia, with higher rates in females. Initiatives to overcome barriers to testing (especially for male patients and older male GPs) need to be established and evaluated.

Additional keywords: epidemiology, prevention, screening.

Acknowledgements

We wish to thank the general practitioners who participated for their generosity. We thank the Australian Government Department of Health and Ageing for supplying the Medicare claims data used for adjustments. We would like to thank Professor G. Berry for helpful advice about the statistical analysis. During the data collection period of this substudy, the BEACH program was funded by the National Prescribing Service, AstraZeneca, Roche Products, Janssen-Cilag, Merck, Sharp and Dohme, Pfizer Australia, Aventis Pharma, the Office of the Australian Safety and Compensation Council (Australian Government Department of Employment and Workplace Training) and the Australian Government Department of Veterans’ Affairs.

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Chlamydia testing in general practice in Australia

Abstract

Acknowledgements

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