P08.29 Web-tool to assess the cost-effectiveness of chlamydia point-of-care tests at the local level

Abstract

Introduction There is a lack of data on the sexual behaviour of patients between being tested for chlamydia, receiving the test result, and being treated. This time-period may be important in the transmission of chlamydia, as infection could continue to be spread to sexual partners whilst awaiting the test result and treatment.We aimed to investigate the sexual behaviours of patients in this time-period in order to investigate the benefits a point-ofcare test (POCT) might bring to clinical practice. Methods A cross-sectional clinical audit of Genito-Urinary Medicine (GUM) clinic attendees in England. Clinic staff conducted a notes review of patients returning for chlamydia treatment following a positive chlamydia test result, and of age-and sexmatched chlamydia negatives attending for initial consultation. Initial consultation data were available for all patients; data on behaviour between test and treatment were available only for chlamydia-positives. The data also served as a sexual history taking audit for the GUM clinics, following British Association of Sexual Health and HIV (BASHH) guidelines. Results Five of nine GUM clinics approached participated (JulyDecember 2014). The sexual history BASHH auditable outcomes completion rates varied from 0-100%. 775 patients (442 females, 353 males) were included in analyses. Males with 2-4 partners, and those who reported never using a condom, were more likely to be chlamydia positive. For 21/143 (14.7%) positive patients who provided data, last new sexual contact was in the period between test and treatment. Conclusion The BASHH 97% data recording target was only consistently met for one of six auditable outcomes, indicating required improvements in sexual history recording by GUM clinics.Patients continue to form new sexual partnerships whilst awaiting chlamydia test results, allowing for the possibility of infecting new sexual partners. POCTs which remove the test to treatment delay could prevent this onward transmission. Introduction Point-of-care tests (POCTs) can eliminate the delay between being tested for chlamydia and receiving the result and treatment, potentially reducing loss to follow-up. However, the cost-effectiveness of POCT implementation depends on multiple factors, including cost-per-test, clinic time, sensitivity and specificity, and the epidemiological impact of POC testing on transmission. P08.29 WEB-TOOL TO ASSESS THE COST-EFFECTIVENESS OF CHLAMYDIA POINT-OF-CARE TESTS AT THE LOCAL LEVELDecision-makers consider a complex range of information when determining potential impact of introducing a POCT. To enable commissioners, providers, POCT manufacturers and others to assess the advantages, disadvantages and uncertainty of POCTs for chlamydia in different local settings, we developed a user-friendly web-based tool (POCTiC): www.poctic.uk.net

A 30-Min Nucleic Acid Amplification Point-of-Care Test for Genital Chlamydia trachomatis Infection in Women: A Prospective, Multi-center Study of Diagnostic Accuracy

“…Future research is required to evaluate its performance in different settings, as well as in male participants. Although previous modelling work has demonstrated that a CT-only POCT could have an epidemiological impact and be cost-saving at the local level ( Harding-Esch et al, 2015 ), dual CT/NG NAAT testing is most commonly employed in GUM/RSH settings in the UK. Therefore, further work is needed to assess the feasibility, acceptability and cost-effectiveness of POCTs for CT in GUM/RSH clinic settings ( Harding-Esch et al, 2017a ).…”

A 30-minute nucleic acid amplification point-of-care test for genitalChlamydia trachomatisinfection in women: a prospective, multi-centre study of diagnostic accuracy

“…Although previous modelling work has demonstrated that a CT-only POCT could have an epidemiological impact and be cost-saving at the local level 45 , dual CT/NG NAAT testing is most commonly employed in GUM/RSH settings in the UK. Therefore, further work is needed to assess the feasibility, acceptability and cost-effectiveness of a CT-only POCT in GUM/RSH clinic settings.…”