P289 A cost-neutral rapid STI service implementation providing the right treatment at the right time to improve patient experience and outcomes

Background A pilot using point-of-care (POC) technology for men with urethritis symptoms found most patients (80%) prefer same day results. We designed a new pathway for managing these patients. Methods Through this pathway, symptomatic men had a nucleic acid amplification test for chlamydia and gonorrhoea (CT/GC NAAT) in clinic, and returned for treatment, usually the same day. Use of Panther (Hologic Inc) at POC provided rapid CT/GC NAAT results within four hours. Microscopy was limited to those testing CT/GC NAAT-negative. GC-culture was sent if GC-positive, when treatment was administered. If CT/GC NAAT-negative and non-gonococcal urethritis (NGU) negative the patient was reassured with information on why they might be experiencing pain (anxiety can increase pelvic floor muscle tone resulting in referred pain and genitourinary symptoms), guided on how to relax their pelvic floor, and advised to re-attend if symptoms persisted. We compared outcomes (Chi-square) over 6 weeks post-implementation in 2020, to 12 weeks in 2014/15. Results Of 265 symptomatic men in the new pathway, 33/265(12.5%) had CT and 30/265 (11.3%) GC, similar to rates (p>0.5) in 2014/15 with 59/431(13.7%) and 45/431(10.4%) respectively. 40/264(15.1%) GC-culture specimens were sent, compared to 385/431 (89.3%)(p With our new pathway, 180/265(67.9%) proceeded to microscopy, with NGU diagnosed in 61 (23%) compared to 385/431(89.3%)(p Conclusions The new rapid service resulted in quicker diagnosis with prompt and specific antimicrobial treatment, reducing the cost and inconvenience of unnecessary microscopy and GC-culture. Patient outcomes and management costs have also improved by reducing reattendance. The new pathway facilitates prompt partner notification, minimising onward STI transmission.