Point-of-care testing for sexually transmissible infections: translating a trial into routine practice

Poster:
Background: The TTANGO randomised controlled trial (2013-2015) evaluated whether use of a molecular point-of-care (POC) test for chlamydia and gonorrhoea could improve the timeliness of treatment in 12 remote Aboriginal communities in Western Australia, Far North Queensland and South Australia. Preliminary results show that use of POC tests by Aboriginal primary care staff substantially reduced the time to treatment compared with standard laboratory testing, the POC tests had very high sensitivity and specificity and were found to be highly acceptable to patients and health service staff.

Aims: Through funding from NHMRC and the Australia Government, the second phase, called ‘TTANGO2’ involves translating POC testing into a routine program and expanding to 33 Aboriginal primary care services. In addition the program will integrate POC testing into sexual health continuous quality improvement (CQI) activities.

Methods: We established a translation framework based on; (i) community engagement and consultation, (ii) POC testing, training and quality management, and (iii) STI CQI activities. A transition workshop was held with health services in November 2015, and participants provided feedback on POC training models and operational aspects and STI testing and management processes. The findings from the workshop, along with acceptability research from the trial, informed the second phase. TTANGO2 is a partnership between Aboriginal health organisations, government, laboratories and researchers.

Results: Program expansion began by engaging a wide network of health services and stakeholders providing them with opportunities for input into the program implementation. To date, 16 primary care services have joined TTANGO2 with the remaining expected to join in the next 9 months. A comprehensive training system was developed and is being delivered in flexible and novel ways. A robust quality management program was designed in collaboration with the Queensland Paediatric Infectious Diseases Laboratory and the National Serology Reference Laboratory to ensure analytical quality and a software system for electronic transfer of results was developed. Sexual health CQI indicators were selected and a CQI working group is being established.

Conclusions: Year one has been productive and the framework has provided a solid basis for translation of the trial. The remaining 3 years of the project will continue to rely on the framework to build the capacity of health services and staff to take ownership of the program, continue POC STI testing as standard practice and integrate POC into their sexual health program.