221638 Identifying Retesting Protocols for Chlamydia Trachomatis: An Evaluation of Infertility Prevention Program Sentinel Sites in California

Tuesday, November 9, 2010 : 9:10 AM - 9:30 AM

Michelle Cantu, MPH , Clinical and Community Health Programs, California Family Health Council, Inc., Los Angeles, CA
Dannelle Pietersz, RN-C, NP, MSN, MPH , Clinical and Community Health Programs, California Family Health Council, Inc., Los Angeles, CA
Rebecca Braun, MPH , Clinical and Community Health Programs, California Family Health Council, Inc., Berkeley, CA
Lani Pasion , Clinical and Community Health Programs, California Family Health Council, Inc., Berkeley, CA
Aileen Barandas, MSN, NP , Clinical and Community Health Programs, California Family Health Council, Inc., Los Angeles, CA
     
Background: Chlamydia Trachomatis (CT) is one of the most common bacterial STIs and repeat CT infection is associated with high risk of PID, ectopic pregnancy and infertility. It is vital to retest for CT, however retesting rates remain low and many opportunities are missed during a client's return visit.

Objectives: Identify CT retesting rates through the Infertility Prevention Program (IPP) Sentinel Site data and establish clinical best practices to increase CT retesting rates.

Methods: Using the 2008-2009 IPP Sentinel Site Prevalence Monitoring data, CT test records from 11 family planning clinics were analyzed. Repeat testing was assessed by matching medical record numbers and visit dates. Of the 62,342 female CT tests, 2,635 (4% positivity) were unique CT infections between January 2007 and December 2008. Subsequently each site was surveyed to identify retesting protocols (reminders via phone, text, email, or charts flagged, EMR reminders, etc.) and best practices.

Results: Of the 2,635 CT positive cases diagnosed, 642 (24%) were retested over two years. We evaluated different clinic approaches to retest their positive clients, focusing on agencies with the highest retesting rates. Agencies that instituted retesting appointments at the treatment visit, reminded clients via phone, offered an incentive and systemized retesting reminders, had the highest rates for retesting.

Conclusions: It is important that CT retesting takes place 3 to 4 months after treatment to address re-infection and future complications. To improve retesting rates, agencies may seek to implement a protocol with several strategies at the clinical level.

Learning Areas:
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related education

Learning Objectives:
1. Identifying the need for retesting and the challenges that limit this service. 2. Describe several innovative strategies to increase retesting rates. 3. Formulate an innovative, multi-method intervention to implement retesting of positive clients.

Keywords: Women's Health, STD

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a qualified to present because I oversee programs in family planning clinics regarding STDs, particularly chlamydia.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4056.0: Beyond family planning