Patient demographics and the utilization of a novel three anatomic site testing panel including rectal self-collection as compared to usual care testing.

BACKGROUND At Kaiser Permanente Mid-Atlantic States (KPMAS), we designed a three anatomic site panel (urine, oropharynx and rectum) with a self-collect feature for rectal sites. We compared the proportion tested at each anatomic site, demographic factors, and HIV status between those who received the three-site panel vs usual care. METHODS Patients entered our laboratories without a prior appointment and underwent urine (usual care - patient collected), oropharynx (lab technician collected) and rectal site (patient collected) testing. Providers recommended the panel to their patients. Patients then had the choice to accept or to reject the panel. Multivariate and logistic regressions were conducted to explore the relationship of age, gender, race and HIV status with GC and CT test results as well as the type of testing (three-site panel vs usual care testing) received. RESULTS 145,854 patients received usual care testing as compared to 9,227 that received the panel. For those that underwent usual care testing 4.0% tested positive for CT and 0.85% for GC. For those that received the panel 9.1% tested positive for CT and 6.4% for GC. Those that received the three-site panel were more likely to test positive for CT (OR = 2.70, CI = 2.46-2.97) and GC (OR = 4.00, CI = 3.59-4.64).White patients were the most likely to receive the panel compared to Black patients (OR = 3.14, CI = 2.96-3.33) Patients with HIV had greater odds of undergoing the panel (OR = 15.62, CI = 14.67-16.64) and of testing positive for CT (OR = 1.27, CI = 1.07-1.51) and GC (OR = 1.39, CI = 1.14-1.68). CONCLUSION Patients who received the panel had higher odds of testing positive for CT and GC compared to patients with usual testing. Physician training may address the racial and gender differences observed in the panel enrollment and increase utilization. Self-collection for rectal sites should lead to higher detection of CT and GC.