Supporting improved chlamydia management in Australian general practice through the design and implementation of tailored resources: An example from the Management of Chlamydia Cases in Australia Study

Conference:

SAPC ASM 2024 - Bristol

Talk Code:

1C.1

Presenter:

Meredith Temple-Smith

Co-authors:

Jacqueline Coombe, Jane Goller, Helen Bittleston, Stephanie Munari, Jane S Hocking

Author institutions:

Department of General Practice and Primary Care Melbourne Medical School The University of Melbourne Australia, and, Sexual Health Unit Melbourne School of Population and Global Health The University of Melbourne Australia

Problem

Chlamydia is the most commonly diagnosed sexually transmissible infection (STI) globally, including in Australia, where most diagnoses occur in general practice. While noting the importance of testing and treatment according to guidelines, internationally the focus is turning to other key aspects of chlamydia management, including effective partner management, timely retesting, and early consideration and detection of complications. The need for improved engagement in case management in Australia is clear, with high reinfection and low retesting rates.

Approach

The Management of Chlamydia Cases in Australia (MoCCA) Study aimed to support improved best practice chlamydia management for clinicians working in general practice through the design and implementation of tailored resources. To inform the development of these resources, we conducted surveys and interviews with general practitioners (GPs) to understand the context and current challenges for chlamydia management, interviews with people diagnosed with chlamydia to understand their needs during a management consultation, and a policy review to understand the jurisdictional context. The resources were piloted in general practice and refined following feedback, then tested in a non-randomised implementation and feasibility trial in 15 general practice clinics across three states in Australia.

Findings

We co-designed a website (www.mocca.org.au) which provides comprehensive chlamydia management information and resources to support best practice chlamydia management including: shortcut text to import into electronic medical records software, patient factsheets for chlamydia and pelvic inflammatory disease, published how-to articles on chlamydia management, resources for utilising patient-delivered partner therapy, flowcharts to support decision-making and postal kits to support timely retesting. Resources were relatively easy to implement, integrated with existing workflows and were reported to improve information delivery with patients. However, not all staff were equally engaged in the study’s uptake, and clinic resource limitations hindered adoption among some clinics.

Consequences

Internationally, the focus of chlamydia control is shifting to case management. MoCCA is the first Australian study to focus on supporting GPs to strengthen their chlamydia management practices via the integration of resources into routine workflow practices. Findings will be used to provide an understanding of how to successfully integrate chlamydia management interventions in general practice, with a view for national scale-up.

Submitted by:

Meredith Temple-Smith

Funding acknowledgement:

MoCCA is funded by the National Health and Medical Research Council (APP1150014). We gratefully acknowledge the partner organisations and institutions who have contributed to MoCCA, as well as the general practices who participated in the study.