Development of an Intervention to Increase ...

1 downloads 0 Views 1MB Size Report
less so amongst receptionists (Mean=4.23). CONCLUSIONS. The findings indicate that clinicians in GP surgeries find offering chlamydia screening outside of ...

Development of an Intervention to Increase Opportunistic Chlamydia Screening in GP surgeries Wallace L M1, Newby K1, Bayley J1, Hogan AH2, McNulty CAM2 1 Coventry University, 2 Health Protection Agency Primary Care Unit, Gloucester.

INTRODUCTION Chlamydia, the most common sexually transmitted infection in the UK, is an important and growing public health problem. The UK government has introduced a National Chlamydia Screening Programme (NCSP) to offer chlamydia screening to sexually active 15-24 year olds (the target group) to address this. Primary Care Trusts (PCTs) currently have a target to screen 35% of the target group. In 2009 16% of young people were screened nationally but only 2.3% of the target group were screened in GP surgeries. Local NCSP Chlamydia Co-ordinators have reported difficulty in engaging General Practitioners (GPs) as one of the greatest obstacles to achieving higher screening rates. Consequently, there is a need to improve opportunistic chlamydia screening in GP surgeries.

AIM This study aimed to inform the development of, and provide baseline data for, an intervention to increase opportunistic chlamydia screening in GP surgeries.

METHOD A cross-sectional survey, developed and refined through earlier qualitative and quantitative studies, was completed by 407 GP surgery staff across 290 GP surgeries. Clinicians and receptionists were asked respectively about their intentions to offer a screen or to provide information about chlamydia and their actual behaviour. They were also asked about barriers to screening within their GP surgery.

FINDINGS Clinical staff (Registered Nurses and GPs): screening behaviour was measured across three items 1. Offering a chlamydia screen within a sexual health-related clinical consultation 2. Offering a chlamydia screen in services used specifically by young people 3. Offering a chlamydia screen within any other clinical consultation Clinicians were more likely to report having offered chlamydia screening to the target group within sexual health consultations (33% reported ‘always’) than in either young persons’ clinics (8.1% reported ‘always’) or other clinical consultations (4.4% reported ‘always’). Nurses were more likely than GPs to report high chlamydia screening behaviour during a sexual health consultation (70.6% of nurses cf. 50% of GPs) and also during an ‘other’ consultation (16.2% of nurses and 3.3% of GPs). There was no difference between these groups where consultations are delivered as part of young people’s services (23.0% of nurses and 23.3% of GPs). Non-Clinical staff (receptionists): behaviour was measured with one item 1. Giving any information relating to chlamydia (including screening) Thirty-five percent of receptionists reported having never offered any information, and a further 45% reported only having offered it in less than a quarter of interactions with the target group. Intentions to offer screening were higher amongst clinicians (Mean=5.03 out of max of 7), and slightly less so amongst receptionists (Mean=4.23).

Examples of factors identified as barriers to offering opportunistic chlamydia screening in the GP surgery were: •Not knowing the Department of Health target for chlamydia screening (78%) •Not knowing the proportion of the target population registered at their GP surgery (58%) •Not being able to estimate the number of screens offered by their GP surgery in last year (83%)

CONCLUSIONS The findings indicate that clinicians in GP surgeries find offering chlamydia screening outside of sexual health consultations the most challenging, and that GPs are less motivated than nurses to offer screening. This signals where it would be beneficial to focus resources. Receptionists’ moderate intentions to provide information about chlamydia, coupled with low behaviour, suggests that this group may perceive the behaviour as beyond their role. Removing barriers to behaviour through, for example, clinicians knowing the number of screens they need to perform per week to meet their surgery target, and tagging patient notes with a record of screening offer/response, may improve screening intentions and behaviour. These findings have been used to inform the content of an intervention to increase opportunistic chlamydia screening currently being delivered in GP surgeries. Presented by Angela Hogan

Contact:Prof. Louise Wallace, Applied Research Centre – Health & Lifestyle Interventions, Room WF102, Coventry University, Priory Street, Coventry, CV1 5FB. Tel + 44 2476 88 5986 Email [email protected]

Suggest Documents