• Nicola Low, Anne McCarthy, Tracy E Roberts, Mia Huengsberg, Emma Sanford, Jonathan A C Sterne, John Macleod, Chris Salisbury, Karl Pye, Aisha Holloway, Andrea Morcom, Rita Patel, Suzanne M Robinson, Paddy Horner, Pelham M Barton, and Matthias Egger.
• Department of Social Medicine, University of Bristol, Bristol BS8 2PR. low@ispm.unibe.ch
• BMJ. 2006 Jan 7; 332 (7532): 14-9.

ObjectiveTo evaluate the effectiveness of a practice nurse led strategy to improve the notification and treatment of partners of people with chlamydia infection.DesignRandomised controlled trial.Setting27 general practices in the Bristol and Birmingham areas.Participants140 men and women with chlamydia (index cases) diagnosed by screening of a home collected urine sample or vulval swab specimen.InterventionsPartner 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.Main Outcome MeasuresPrimary 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.Results65.3% (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.ConclusionPractice 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.

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