Chlamydia point-of-care testing: where are we now?

Jain, Anu; Ison, Catherine

doi:10.1136/sextrans-2012-050834

Cited by 12 publications

(9 citation statements)

References 7 publications

(4 reference statements)

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“…By reducing loss to follow-up, chlamydia/gonorrhoea POC testing could be particularly useful with groups who are less likely to return for treatment,2 5 7 including high-risk groups, such as men who have sex with men and commercial sex workers. Patients who do not return, or are lost to follow-up, may comprise up to 10% of all chlamydia diagnoses,5 although this may be less in GUM clinics.…”

Section: Discussionmentioning

confidence: 99%

Mapping patient pathways and estimating resource use for point of care versus standard testing and treatment of chlamydia and gonorrhoea in genitourinary medicine clinics in the UK

et al. 2014

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ObjectivesWe aimed to explore patient pathways using a chlamydia/gonorrhoea point-of-care (POC) nucleic acid amplification test (NAAT), and estimate and compare the costs of the proposed POC pathways with the current pathways using standard laboratory-based NAAT testing.Design/participantsWorkshops were conducted with healthcare professionals at four sexual health clinics representing diverse models of care in the UK. They mapped out current pathways that used chlamydia/gonorrhoea tests, and constructed new pathways using a POC NAAT. Healthcare professionals' time was assessed in each pathway.Outcome measureThe proposed POC pathways were then priced using a model built in Microsoft Excel, and compared to previously published costs for pathways using standard NAAT-based testing in an off-site laboratory.ResultsPathways using a POC NAAT for asymptomatic and symptomatic patients and chlamydia/gonorrhoea-only tests were shorter and less expensive than most of the current pathways. Notably, we estimate that POC testing as part of a sexual health screen for symptomatic patients, or as stand-alone chlamydia/gonorrhoea testing, could reduce costs per patient by as much as £16 or £6, respectively. In both cases, healthcare professionals' time would be reduced by approximately 10 min per patient.ConclusionsPOC testing for chlamydia/gonorrhoea in a clinical setting may reduce costs and clinician time, and may lead to more appropriate and quicker care for patients. Further study is warranted on how to best implement POC testing in clinics, and on the broader clinical and cost implications of this technology.

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Section: Discussionmentioning

confidence: 99%

Mapping patient pathways and estimating resource use for point of care versus standard testing and treatment of chlamydia and gonorrhoea in genitourinary medicine clinics in the UK

et al. 2014

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“…Gift et al 15 have demonstrated that test sensitivity could be balanced against return rates for treatments. A systematic review was conducted in 2010 and others have concluded that a chlamydia/gonorrhoea POCT with sufficiently good performance for routine clinical use was not currently available 9 10 29. However, these papers did not include new generation POC NAAT tests.…”

Section: Discussionmentioning

confidence: 99%

An early evaluation of clinical and economic costs and benefits of implementing point of care NAAT tests forChlamydia trachomatisandNeisseria gonorrhoeain genitourinary medicine clinics in England

et al. 2013

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ObjectivesTo estimate the costs and benefits of clinical pathways incorporating a point of care (POC) nucleic acid amplification test (NAAT) for chlamydia and gonorrhoea in genitourinary medicine (GUM) clinics compared with standard off-site laboratory testing.MethodWe simulated 1.2 million GUM clinic attendees in England. A simulation in Microsoft Excel was developed to compare existing standard pathways of management for chlamydia and gonorrhoea with a POC NAAT. We conducted scenario analyses to evaluate the robustness of the model findings. The primary outcome was the incremental cost-effectiveness ratio. Secondary outcomes included the number of inappropriate treatments, complications and transmissions averted.ResultsThe baseline cost of using the point of POC NAAT was £103.9 million compared with £115.6 million for standard care. The POC NAAT was also associated with a small increase of 46 quality adjusted life years, making the new test both more effective and cheaper. Over 95 000 inappropriate treatments might be avoided by using a POC NAAT. Patients receive diagnosis and treatment on the same day as testing, which may also prevent 189 cases of pelvic inflammatory disease and 17 561 onward transmissions annually.DiscussionReplacing standard laboratory tests for chlamydia and gonorrhoea with a POC test could be cost saving and patients would benefit from more accurate diagnosis and less unnecessary treatment. Overtreatment currently accounts for about a tenth of the reported treatments for chlamydia and gonorrhoea and POC NAATs would effectively eliminate the need for presumptive treatment.

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“…In their topical editorial, Jain and Ison state that ‘testing (for chlamydia) is a crucial part of any effective control strategy’ 1. In January 2013 we conducted a pilot study of Chlamydia trachomatis and Neisseria gonorrhoea testing in female students at Lambeth Further Education College, London to assess recruitment to a possible prevention of pelvic infection-2 screening trial 2…”

mentioning

confidence: 99%

Chlamydia testing: where are we now? Recruiting high-risk women to a pilot STI screening trial

et al. 2013

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Chlamydia point-of-care testing: where are we now?

Cited by 12 publications

References 7 publications

Mapping patient pathways and estimating resource use for point of care versus standard testing and treatment of chlamydia and gonorrhoea in genitourinary medicine clinics in the UK

Mapping patient pathways and estimating resource use for point of care versus standard testing and treatment of chlamydia and gonorrhoea in genitourinary medicine clinics in the UK

An early evaluation of clinical and economic costs and benefits of implementing point of care NAAT tests forChlamydia trachomatisandNeisseria gonorrhoeain genitourinary medicine clinics in England

Chlamydia testing: where are we now? Recruiting high-risk women to a pilot STI screening trial

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