Wednesday, March 12, 2008
Chlamydia trachomatis (CT) and Neisseria gonorrhoea (GC) infections are frequently asymptomatic in women, and recurrent infection is common. As a result, the Centers for Disease Control and Prevention (CDC) recommends that clinicians retest women who have been diagnosed with CT or GC 3 months after treatment. Other organizations have similar guidelines
To describe repeat CT and GC testing practices with commercially-insured women.
We used the MarketScan database, containing insurance claims for over 7 million persons. We analyzed outpatient claims for 2003 for women 15-25 years of age. We defined CT and GC presumptive cases as women with either an International Classification of Diseases (ICD-9) code indicating CT or GC infection or a Current Procedures Terminology (CPT) code indicating a CT or GC test plus a drug claim for treatment 14 days before or 30 days after the test date. Women with claims for CT or GC testing alone were considered non-cases. We compared subsequent testing rates between presumptive cases and non-cases.
In 2003, 98,106 women were tested or diagnosed with CT or GC; 23 % were retested within the year (30% of presumptive cases vs. 17% of non-cases, p < 0.01). About 18% of presumptive cases were retested within 2-4 months, but repeat testing within 30 days was more common (32%). Most claims for retesting among non-cases occurred after 120 days (54%). Time to retesting was significantly associated with whether the woman was a case or not (p < 0.001).
Among commercially-insured women with CT or GC, retesting does not occur often, and when it does it is frequently very soon after treatment.
More research needs to be done in this area to explore motivations for retesting among women and health care providers' willingness to adhere to health care recommendations.