Low Nicola, McCarthy Anne, Roberts Tracy E, Huengsberg Mia, Sanford Emma, Sterne Jonathan A C, Macleod John, Salisbury Chris, Pye Karl, Holloway Aisha, Morcom Andrea, Patel Rita, Robinson Suzanne M, Horner Paddy, Barton Pelham M, Egger Matthias
Department of Social Medicine, University of Bristol, Bristol BS8 2PR.
BMJ. 2006 Jan 7;332(7532):14-9. doi: 10.1136/bmj.38678.405370.7C. Epub 2005 Dec 15.
To evaluate the effectiveness of a practice nurse led strategy to improve the notification and treatment of partners of people with chlamydia infection.
Randomised controlled trial.
27 general practices in the Bristol and Birmingham areas.
140 men and women with chlamydia (index cases) diagnosed by screening of a home collected urine sample or vulval swab specimen.
Partner notification at the general practice immediately after diagnosis by trained practice nurses, with telephone follow up by a health adviser; or referral to a specialist health adviser at a genitourinary medicine clinic.
Primary outcome was the proportion of index cases with at least one treated sexual partner. Specified secondary outcomes included the number of sexual contacts elicited during a sexual history, positive test result for chlamydia six weeks after treatment, and the cost of each strategy in 2003 sterling prices.
65.3% (47/72) of participants receiving practice nurse led partner notification had at least one partner treated compared with 52.9% (39/68) of those referred to a genitourinary medicine clinic (risk difference 12.4%, 95% confidence interval -1.8% to 26.5%). Of 68 participants referred to the clinic, 21 (31%) did not attend. The costs per index case were 32.55 pounds sterling for the practice nurse led strategy and 32.62 pounds sterling for the specialist referral strategy.
Practice based partner notification by trained nurses with telephone follow up by health advisers is at least as effective as referral to a specialist health adviser at a genitourinary medicine clinic, and costs the same. Trial registration Clinical trials: NCT00112255.
评估由执业护士主导的策略在改善衣原体感染患者性伴侣的通知及治疗方面的有效性。
随机对照试验。
布里斯托尔和伯明翰地区的27家普通诊所。
140名通过筛查家庭采集的尿液样本或外阴拭子标本诊断为衣原体感染的男性和女性（索引病例）。
诊断后由经过培训的执业护士在普通诊所立即通知性伴侣，并由健康顾问进行电话随访；或转诊至泌尿生殖医学诊所的专科健康顾问处。
主要结局是至少有一名接受治疗的性伴侣的索引病例比例。特定的次要结局包括性病史中引出的性接触次数、治疗六周后衣原体检测呈阳性的结果，以及2003年英镑价格下每种策略的成本。
接受执业护士主导的性伴侣通知的参与者中，65.3%（47/72）至少有一名伴侣接受了治疗，而转诊至泌尿生殖医学诊所的参与者中这一比例为52.9%（39/68）（风险差异12.4%，95%置信区间-1.8%至26.5%）。转诊至诊所的68名参与者中，21名（31%）未就诊。执业护士主导策略下每个索引病例的成本为32.55英镑，专科转诊策略为32.62英镑。
由经过培训的护士进行基于诊所的性伴侣通知并由健康顾问进行电话随访，至少与转诊至泌尿生殖医学诊所的专科健康顾问一样有效，且成本相同。试验注册 临床试验：NCT00112255
