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    Guideline change affects chlamydia screening rate


    “Chlamydia is the most commonly reported sexually transmitted infection in the United States, and in females, it can be associated with more serious conditions, including pelvic inflammatory disease, chronic pain, and infertility. Based on this information, the US Preventive Services Task Force recommends screening for chlamydia in sexually active women age 24 years and younger because they have the highest burden of disease,” said Dr Ursu, clinical lecturer, department of family medicine, University of Michigan, Ann Arbor.

    “Our study shows the importance of unlinking chlamydia screening from the pelvic examination and cervical cancer screening.”

    The investigators also believe their findings point to a need for identifying strategies that will ensure appropriate chlamydia screening. One barrier they identified among family practitioners at the University of Michigan is a low rate of awareness about the availability of a chlamydia urine test.

    “Chlamydia testing has been closely linked with the pelvic exam and Pap testing such that physicians were relying on the cervical swab collection for the chlamydia screen. In our study, almost two-thirds of the chlamydia screens were concurrent with Pap testing before the guideline change, compared with just over 10% after the 2009 guideline was released,” Dr Ursu said.

    “It is important for clinicians to know that chlamydia screening can be easily done with a urine test even if a pelvic exam is not being performed.” 

    With the aims of improving capture rates for chlamydia screening among sexually active females ages 16 to 24 and streamlining the screening process, Dr Ursu and colleagues from the family medicine department collaborated with colleagues in ob/gyn, internal medicine, pediatrics, and the University Health Service to introduce an electronic medical record-based reminder protocol. They are preparing to analyze their data to evaluate the success of the program and ultimately will be looking to see if higher chlamydia screening rates translate into reduced consequences of chlamydia infection.



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