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

Senok, A., Wilson, P., Reid, M., Scoular, A., Craig, N., McConnachie, A. , Fitzpatrick, B. and MacDonald, A. (2005) Can we evaluate population screening strategies in UK general practice? A pilot randomised controlled trial comparing postal and opportunistic screening for genital chlamydial infection. Journal of Epidemiology and Community Health, 59(3), pp. 198-204. (doi: 10.1136/jech.2004.021584)

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. MAIN RESULTS: 38% (85/221) of the approached practices expressed interest in the study. Data were collected successfully from the 3 participating practices, although intensive support was required. There were considerable workload implications for staff, both in relation to implementing the screening strategies and managing the research process. 124 of the 600 women opted out of the study. During the four-month study period, 55% (81/146) of the control group attended their practice but none was offered screening. 59% (80/136) women in the opportunistic group attended their practice of whom 55% (44/80) were offered screening. Of those, 64% (28/44) accepted, representing 21% of the opportunistic group. 48% (59/124) of the postal group returned samples. CONCLUSION: A randomised controlled trial comparing postal and opportunistic screening for chlamydial infection in general practice is feasible, though resource intensive. There may be problems with generalising from screening trials in which patients may opt out from the offer of screening.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: McConnachie, Professor Alex and Wilson, Prof Philip and Reid, Professor Margaret and Fitzpatrick, Dr Bridie and Scoular, Dr Anne
• Authors: Senok, A., Wilson, P., Reid, M., Scoular, A., Craig, N., McConnachie, A., Fitzpatrick, B., and MacDonald, A.
• Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Nursing and Health Care
• Journal Name: Journal of Epidemiology and Community Health
• Publisher: BMJ Publishing Group
• ISSN: 0143-005X
• Copyright Holders: Copyright © 2005 BMJ Publishing Group
• First Published: First published in Journal of Epidemiology and Community Health 59(3):198-204
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher