The effects of an STD educational intervention on follow-up appointment keeping and medication-taking compliance

Article Abstract:

Gonorrhea and chlamydia are both sexually transmitted bacterial diseases. Of the patients attending a sexually transmitted disease (STD) clinic, 32 percent of men and 63 percent of women have both infections. Compliance with antibiotic treatment regimens is essential for eliminating both bacterial infections. However, many of the patients attending an STD clinic do not take medication as prescribed or complete the drug therapy; up to 92 percent of the patients receiving short-term therapy are noncompliant. Six educational strategies aimed at reducing drug therapy noncompliance in STD patients are: tailoring the time medications are to be taken to fit the patient's lifestyle; providing detailed written information about the desired behavior; having the caregiver repeat the instructions verbally and provide written information; having the caregiver describe the desired behavior in an authoritative manner; quizzing the patient verbally while providing instructions; and giving a patient a self-monitoring device that helps him or her to keep track of medication doses. A combination of these six strategies was used to see if medication compliance and follow up clinic visit compliance can be improved. Patients from a Tennessee STD clinic were divided equally into two groups; one received the experimental educational program and the other was given information according to the clinic's standard protocol. Of the 340 male patients diagnosed and treated for gonorrhea, 224 (66 percent) returned to the clinic for their follow-up exam. Results showed that 121 patients returned out of the 170 (71 percent) in the group which received the experimental educational program. This was not statistically different than the group which received the standard information. The type of person giving the educational information, medical or nonmedical personnel, did not affect the follow-up visit rate. Moreover, the educational intervention did not affect behaviors regarding medication compliance. Both groups in this study reported high medication compliance. These results may be related to biases inherent in the method of self-reporting. It may be necessary to check medication levels in the blood through serial blood tests to accurately measure compliance with drug therapy regimens.

Research, Methods, Evaluation, Patient compliance, Patient education, Self medication

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Noeggerath and "latent gonorrhea." (editorial)

Article Abstract:

Emil Noeggerath was a German gynecologist who worked in New York in the second half of the 19th century. In 1872, he published a controversial report on what he termed 'latent gonorrhea.' Based on studies of 50 women with pelvic inflammation, he concluded that they had gonorrhea and that the infection had been passed to them by their husbands who previously had gonorrhea, but were thought cured when they became asymptomatic (without symptoms). Because the men did not have acute symptoms of gonorrhea, Noeggerath theorized that the infection had remained latent, that is, did not cause symptoms, and that this 'latent gonorrhea' could be highly infective. Noeggerath concluded that gonorrhea could be a latent infection in both males and females, that it could lead to sterility, and that it could affect organs not usually associated with the disease, including all the organs of the female genital tract. The American gynecological community was not accepting of his findings, particularly the idea that men who were apparently cured of gonorrhea could still be infective. Time has shown that Noeggerath's theory of latent gonorrhea infection was correct. However, he did overstate the actual prevalence of latent disease in men and was wrong in his idea of how the disease progressed in women. The bacteria that causes gonorrhea was identified soon after his theory was published. It is possible that some of the symptoms he attributed to gonorrhea were actually caused by other infections. Noeggerath, although not noted at the time, was a major contributor in the study of sexually transmitted diseases. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, History, Gonorrhea, Neisseria gonorrhoeae, Gynecology, editorial

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The effect of video interventions on improving knowledge and treatment compliance in the sexually transmitted disease clinic setting: lesson for HIV health education

Article Abstract:

Use of videos in sexually transmitted disease (STD) clinics appears to have a strong influence on patrons' knowledge and attitudes about STDs, HIV and condoms but little effect on their treatment compliance. Little is known about which methods of patient education are most successful in increasing people's knowledge and reducing risk behaviors. In an analysis of eight studies on the effectiveness of videos, videos were more effective than any other educational approach - programmed learning guides, lectures with question-and-answer periods and counseling - in improving people's knowledge. However, videos were as unsuccessful as all other methods in improving patients's compliance with medical regimens and regular condom use. The challenge to health educators remains finding a way to produce behavioral changes among those at risk for STDs and HIV infection.

Usage, HIV infection, HIV infections, Video recordings

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