Improving chlamydia knowledge should lead to increased chlamydia testing among Australian general practitioners: A cross-sectional study of chlamydia testing uptake in general practice

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Abstract

Background: Female general practitioners (GPs) have higher chlamydia testing rates than male GPs, yet it is unclear whether this is due to lack of knowledge among male GPs or because female GPs consult and test more female patients. Methods: GPs completed a survey about their demographic details and knowledge about genital chlamydia. Chlamydia testing and consultation data for patients aged 16-29 years were extracted from the medical records software for each GP and linked to their survey responses. Chi-square tests were used to determine differences in a GP's knowledge and demographics. Two multivariable models that adjusted for the gender of the patient were used to investigate associations between a GP and their chlamydia testing rates - Model 1 included GPs' characteristics such as age and gender, Model 2 excluded these characteristics to specifically examine any associations with knowledge. Results: Female GPs were more likely than male GPs to know when to re-test a patient after a negative chlamydia test (18.8% versus 9.7%, p = 0.01), the correct symptoms suggestive of PID (80.5% versus 67.8%, p = 0.01) and the correct tests for diagnosing PID (57.1% versus 42.6%, p = 0.01). Female GPs tested 6.5% of patients, while male GPs tested 2.2% (p < 0.01). Model 1 found factors associated with chlamydia testing were being a female GP (OR = 2.5, 95% CI: 1.9, 3.3) and working in a metropolitan clinic (OR = 3.2; 95% CI: 2.4, 4.3). Model 2 showed that chlamydia testing increased as knowledge of testing guidelines improved (3-5 correct answers - AOR = 2.0, 95% CI: 1.0, 4.2; 6+ correct answers - AOR = 2.9, 95% CI: 1.4, 6.2). Conclusions: Higher rates of chlamydia testing are strongly associated with GPs who are female, based in a metropolitan clinic and among those with more knowledge of the recommended guidelines. Improving chlamydia knowledge among male GPs may increase chlamydia testing.

Original languageEnglish
Article number584
JournalBMC Infectious Diseases
Volume14
Issue number1
DOIs
Publication statusPublished - 2014
Externally publishedYes

Bibliographical note

Funding Information:
This survey was conducted as part of the Department of Health and Ageing-funded Australian Chlamydia Control Effectiveness Pilot. Additional funding and support has been provided by National Health and Medical Research Council, Department of Health – Victoria, NSW Health, Royal Australian College of General Practitioners, and the Australian Primary Health Care Nurses Association. We thank: Jane Tomnay, from the Centre for Excellence in Rural Sexual Health, University of Melbourne for providing resources, support and advice on conducting this study in rural Victoria, and Dr. Douglas Boyle and the GHRANITE team, from the Health Informatics Unit, University of Melbourne; Carolyn Murray and Chris Bourne, from the Sexually Transmissible Infections Program Unit, NSW Health, for providing advice and resources. We acknowledge the support from pathology providers in providing chlamydia testing data for the analysis and thank Capital Pathology, Dorevitch Pathology, Douglass Hanly Moir Pathology, Healthscope Pathology, Institute of Clinical Pathology & Medical Research, Melbourne Pathology, Pathology North, Pathology Queensland, South Australia Pathology, St John of God Pathology, St. Vincent’s Health Pathology, Sullivan and Nicolaides Pathology, and Victorian Cytology Service. A big thank you to the ACCEPt research team of Alaina Vaisey, Rebecca Lorch, Belinda Ford, Michelle King, Eris Smyth, Jennifer Walker, Dyani Lewis, Lisa Edward, Chantal Maloney, and Anne Shaw for their help with recruiting clinics and providing them ongoing support. We acknowledge input from the ACCEPt Consortium of investigators: Marcus Chen and Lena Sanci, from the University of Melbourne; David Wilson, and David Regan from the University of New South Wales; Sepehr Tabrizi, from the Royal Women’s Hospital; James Ward, from Baker IDI and University of New South Wales; Marian Pitts and Anne Mitchell, from La Trobe University; Rob Carter from Deakin University; Marion Saville and Dorota Gertig, from the Victorian Cytology Service; Margaret Hellard, from the Burnet Institute; Nicola Low, from the University of Bern; and John Imrie, from the University of KwaZulu-Natal.

Publisher Copyright:
© 2014 Yeung et al.

Keywords

  • Chlamydia testing
  • General practice
  • General practitioner education
  • Sexual health knowledge

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