Pelvic Inflammatory disease in adolescents: Are there clues to tell us who will seek follow-up care

Objective: The CDC advises providers to determine an adolescents ability to ‘tolerate an outpatient regimen' in order to make a decision about dispositions for pelvic inflammatory disease (PID). The objective of this study was to determine if there are baseline factors that could be used for risk-stratification prior to making a decision about outpatient management for adolescents with PID based on their ability to complete follow-up visits. Methods: 126 adolescents in a randomized trial of a behavioral intervention for PID were examined. Patients completed computerized self interviews at baseline and were scheduled to see a disease intervention specialist at 2 weeks. The key outcome was completion of the 2 week interview. Reproductive health history (STD, pregnancy, sexual debut, lifetime partners) and home environment stability (family structure, insurance, school status) were evaluated as primary predictors using regression analysis. Results: Half of the participants had a prior history of STI and/or pregnancy, most resided in female-headed, single parent households, and had more than one lifetime partners. Of the factors examined, only having less than one lifetime partner was associated with being more likely to complete the follow-up visits ( AOR 8.1, 95% CI: 1.0; 65.3, p= 0.05), controlling for group status. Conclusion: Among adolescents with PID, only the least sexually experienced girls are more likely to complete the 2 week follow-up. This suggests that risk-based assessments may be less useful in determining ability to tolerate outpatient PID regimens and that caution should be used in managing the disposition of affected girls.