An observational study to evaluate three pilot programmes of retesting chlamydia-positive individuals within 6 months in the South West of England

OBJECTIVES: To evaluate 3 pilot chlamydia retesting programmes in South West England which were initiated prior to the release of new National Chlamydia Screening Programme (NCSP) guidelines recommending retesting in 2014. METHODS: Individuals testing positive between August 2012 and July 2013 in Bristol (n=346), Cornwall (n=252) and Dorset (n=180) programmes were eligible for inclusion in the retesting pilots. The primary outcomes were retest within 6 months (yes/no) and repeat diagnosis at retest (yes/no), adjusted for area, age and gender. RESULTS: Overall 303/778 (39.0%) of participants were retested within 6 months and 31/299 (10.4%) were positive at retest. Females were more likely to retest than males and Dorset had higher retesting rates than the other areas. CONCLUSIONS: More than a third of those eligible were retested within the time frame of the study. Chlamydia retesting programmes appear feasible within the context of current programmes to identify individuals at continued risk of infection with relatively low resource and time input

Cost-effectiveness analysis of a physician-implemented medication screening tool in older hospitalised patients in Ireland

Background: A recent randomised controlled trial conducted in an Irish University teaching hospital that evaluated a physician-implemented medication screening tool, demonstrated positive outcomes in terms of a reduction in incident adverse drug reactions. Objective: The present study objective was to evaluate the cost effectiveness of physicians applying this screening tool to older hospitalised patients compared with usual hospital care in the context of the earlier randomised controlled trial. Method: We used a cost-effectiveness analysis alongside a conventional outcome analysis in a cluster randomised controlled trial. Patients in the intervention arm (n = 360) received a multifactorial intervention consisting of medicines reconciliation, communication with patients’ senior medical team, and generation of a pharmaceutical care plan in addition to usual medical and pharmaceutical care. Control arm patients (n = 372) received usual medical and pharmaceutical care only. Incremental cost effectiveness was examined in terms of costs to the healthcare system and an outcome measure of adverse drug reactions during inpatient hospital stay. Uncertainty in the analysis was explored using a cost-effectiveness acceptability curve. Results: On average, the intervention arm was more costly but was also more effective. Compared with usual care (control), the intervention was associated with a non-statistically significant increase of €877 (95% confidence interval − €1807, €3561) in the mean healthcare cost, and a statistically significant decrease of − 0.164 (95% confidence interval − 0.257, − 0.070) in the mean number of adverse drug reaction events per patient. The associated incremental cost-effectiveness ratio per adverse drug reaction averted was €5358. The probability of the intervention being cost effective at threshold values of €0, €5000 and €10,000 was 0.236, 0.455 and 0.680, respectively. Conclusion: Based on the evidence presented, this physician-led intervention is not likely to be cost effective compared with usual hospital care. To inform future healthcare policy decisions in this field, more economic analyses of structured medication reviews by other healthcare professionals and by computerised clinical decision support software need to be conducted

Young Contemporaries '80 = Jeunes contemporains '80

This catalogue of works by 72 Canadian artists is prefaced by comments on the jurying process. Biographical notes

Brian Jones

Jones' integration of realist and romantic painting is related to the influence of Jack Chambers and Sir Stanley Spencer. Biographical notes

London/Banff Exchange

O'Brien describes the Banff facilities and atmosphere which have been proved conducive to artistic production during the 20th century. Biographical notes on the 21 exhibiting artists

London and Area Artists, Part I

Prefaced by notes on the artistic activity and strong support of regionalism in London in the 1960s, the catalogue documents this exhibition of 27 artists. Biographical notes. 2 bibl. ref

Jack Chambers : Indian Drawings

O'Brien describes how Chambers' sojourn in an ashram in northern India to fight acute leukemia motivated a series of drawings and influenced the work he did during the remaining three years of his life. 3 bibl. ref

London and Area Artists Exhibition, Part II

Prefaced with notes on the types of work produced in London in 1981, the catalogue documents this exhibition of 26 artists. Biographical notes