by Claire Taylor
Sara Day2, Sophie Jones2, Emma Ostridge3, Efejiro Ashano1, Vanessa Apea1,
1Preventx, 2Chelsea and Westminster Hospitals NHS Foundation Trust, 3Lloyds Pharmacy Online Doctor
Following triage, patients diagnosed with chlamydia (CT) via an STI screening e-service, collaboratively funded by 30/33 London local authorities, may be offered remote management with an option to receive treatment via post or via face-to-face dispensing at a community pharmacy. Exploring the uptake and preferences of remote CT treatment provides important insight for tailoring services and mitigating inequities. We describe the cohort of patients using a London e-service and opting for remote CT treatment in 2022.
We conducted a retrospective analysis of those who were diagnosed with CT and chose remote treatment between Q1–Q4 2022 and compared the choice of treatment access (postal versus pharmacy), analysing by age, ethnicity and indices of multiple deprivation (IMD).
Of the 19468 who opted for remote CT treatment, 14360 (73.8%) selected postal treatment. Users under 25 were 7% more likely (24.4% versus 31.6%) to opt for postal treatment than those over 25. As users aged, the probability of pharmacy collection increased, from 24.9% (980/3934) (ages 18–21) to 40.09% (89/222) (ages 55+). 42.7% (8327/19380) of those receiving remote treatment were from a racially minoritised background (RMB), with 74.3% (6190/8327) opting for postal treatment. Those of Bangladeshi background were more likely opt more community pharmacy than their white counterparts (40.4% versus 26.9%). Bangladeshi users were also 15% more likely than those from other RMBs to use the pharmacy (40.4% versus 25.07%). Users living in the bottom two IMDs were 3% less likely (27.25% versus 24.2%) to opt for pharmacy collection than those in higher deciles.
Postal treatment was the preferred option by those under 25 and those from RMBs, both of whom are key populations in the diagnosis and prevention of sexually transmitted infections. This data must be supplemented with mapping of pharmacy locations and qualitative insight to gain a deeper understanding of patient decision-making.