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  • Can we evaluate population screening strategies in UK general practice? A pilot randomised controlled trial comparing postal and opportunistic screening for genital chlamydial infection

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Evidence based public health policy and practice
Can we evaluate population screening strategies in UK general practice? A pilot randomised controlled trial comparing postal and opportunistic screening for genital chlamydial infection
  1. Abiola Senok1,
  2. Phil Wilson1,
  3. Margaret Reid2,
  4. Anne Scoular3,
  5. Neil Craig2,
  6. Alex McConnachie1,
  7. Bridie Fitzpatrick1,
  8. Alison MacDonald4
  1. 1General Practice and Primary Care, Division of Community Based Sciences, University of Glasgow, Glasgow, UK
  2. 2Public Health and Health Policy, Division of Community Based Sciences, University of Glasgow
  3. 3Greater Glasgow NHS Board, Glasgow, UK
  4. 4Bridgeton and Dennistoun LHCC, Bridgeton Health Centre, Glasgow, UK
  1. Correspondence to:
 Dr P Wilson
 General Practice and Primary Care, Division of Community Based Sciences, University of Glasgow, 1 Horselethill Road, Glasgow G12 9LX, UK; p.wilsonclinmed.gla.ac.uk

Abstract

Study objective: To assess whether opportunistic and postal screening strategies for Chlamydia trachomatis can be compared with usual care in a randomised trial in general practice.

Design: Feasibility study for a randomised controlled trial.

Setting: Three West of Scotland general medical practices: one rural, one urban/deprived, and one urban/affluent.

Participants: 600 women aged 16–30 years, 200 from each of three participating practices selected at random from a sample of West of Scotland practices that had expressed interest in the study. The women could opt out of the study. Those who did not were randomly assigned to one of three groups: postal screening, opportunistic screening, or usual care.

Results: 38% (85 of 221) of the approached practices expressed interest in the study. Data were collected successfully from the three participating practices. There were considerable workload implications for staff. Altogether 124 of the 600 women opted out of the study. During the four month study period, 55% (81 of 146) of the control group attended their practice but none was offered screening. Some 59% (80 of 136) women in the opportunistic group attended their practice of whom 55% (44 of 80) were offered screening. Of those, 64% (28 of 44) accepted, representing 21% of the opportunistic group. Forty eight per cent (59 of 124) of the postal group returned samples.

Conclusion: A randomised controlled trial comparing postal and opportunistic screening for chlamydial infection in general practice is feasible, although resource intensive. There may be problems with generalising from screening trials in which patients may opt out from the offer of screening.

https://doi.org/10.1136/jech.2004.021584

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    Footnotes

    • Funding: this study was funded by the Scottish Executive Chief Scientist Office.

    • Competing interests: none declared.

    • The study protocol received approval from the following ethics committees: Greater Glasgow Primary Care Trust, Lanarkshire Primary Care Trust, and Forth Valley Primary Care Trust.

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