Evidence map›Paper›PMID 26822715›Full record

ArticleBMC public health2016

The acceptability and cost of a home-based chlamydia retesting strategy: findings from the REACT randomised controlled trial.

K S Smith, J M Kaldor, J S Hocking, M S Jamil, A M McNulty, P Read, C S Bradshaw, M Y Chen, C K Fairley, H Wand and 9 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC public health, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

K S SmithThe Kirby Institute, UNSW Australia, Sydney, Australia. ksmith@kirby.unsw.edu.au.
J M KaldorThe Kirby Institute, UNSW Australia, Sydney, Australia.
J S HockingMelbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
M S JamilThe Kirby Institute, UNSW Australia, Sydney, Australia.
A M McNultySydney Sexual Health Centre, Sydney, Australia.
P ReadKirketon Road Centre, Sydney, Australia.
C S BradshawMelbourne Sexual Health Centre, Melbourne, Australia.
M Y ChenMelbourne Sexual Health Centre, Melbourne, Australia.
C K FairleyMelbourne Sexual Health Centre, Melbourne, Australia.
H WandThe Kirby Institute, UNSW Australia, Sydney, Australia.
K WorthingtonMelbourne Sexual Health Centre, Melbourne, Australia.
S BlakeSydney Sexual Health Centre, Sydney, Australia.
V KnightSydney Sexual Health Centre, Sydney, Australia.
W RawlinsonSerology and Virology Division, (SAViD) SEALS Microbiology, Prince of Wales Hospital, Sydney, Australia.
M SavilleVCS Pathology, Melbourne, Australia.
S N TabriziDepartment of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia.
S M GarlandDepartment of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia.
B DonovanThe Kirby Institute, UNSW Australia, Sydney, Australia.
R GuyThe Kirby Institute, UNSW Australia, Sydney, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChlamydia retesting three months after treatment is recommended to detect reinfections, but retesting rates are typically low. The REACT (retest after Chlamydia trachomatis) randomised trial demonstrated that home-based retesting using postal home-collection kits and SMS reminders, resulted in substantial improvements in retesting rates in women, heterosexual men and men who have sex with men (MSM), with detection of more repeat positive tests compared with SMS reminder alone. In the context of this trial, the acceptability of the home-based strategy was evaluated and the costs of the two strategies were compared.

methodsREACT participants (200 women, 200 heterosexual men, 200 MSM) were asked to complete an online survey that included home-testing acceptability and preferred methods of retesting. The demographics, sexual behaviour and acceptability of home collection were compared between those preferring home-testing versus clinic-based retesting or no preference, using a chi-square test. The costs to the health system of the clinic-based and home retesting strategies and the cost per infection for each were also compared.

resultsOverall 445/600 (74 %) participants completed the survey; 236/445 from the home-testing arm, and 141 of these (60 %) retested at home. The majority of home arm retesters were comfortable having the kit posted to their home (86 %); found it easy to follow the instructions and collect the specimens (96 %); were confident they had collected the specimens correctly (90 %); and reported no problems (70 %). Most (65 %) preferred home retesting, 21 % had no preference and 14 % preferred clinic retesting. Comparing those with a preference for home testing to those who didn't, there were significant differences in being comfortable having a kit sent to their home (p = 0.045); not having been diagnosed with chlamydia previously (p = 0.030); and living with friends (p = 0.034). The overall cost for the home retest pathway was $154 (AUD), compared to $169 for the clinic-based retesting pathway and the cost per repeat infection detected was $1409 vs $3133.

conclusionsAmong individuals initially diagnosed with chlamydia in a sexual health clinic setting, home-based retesting was shown to be highly acceptable, preferred by most participants, and cost-efficient. However some clients preferred clinic-based testing, often due to confidentiality concerns in their home environment. Both options should be provided to maximise retesting rates.

trial registrationThe trial was registered with the Australia New Zealand Clinical Trials Registry on September 9, 2011: ACTRN12611000968976.

Indexed as

AdultChlamydia InfectionsChlamydia trachomatisCost-Benefit AnalysisFemaleHumansMaleMass ScreeningPatient CompliancePatient PreferenceReagent Kits, DiagnosticSelf CareYoung AdultReagent Kits, Diagnostic

Identifiers

PMID26822715
PMCPMC4730759

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.