Is chlamydia testing in general practice sustained when financial incentives or audit feedback are removed: a cluster RCT

Abstract

Financial incentives (FI) and audit+feedback (AF) are often used to improve general practitioner (GP) performance. In the Australian Chlamydia Control Effectiveness Pilot (ACCEPt), a cluster-randomised controlled trial (RCT), GPs in the intervention arm received a FI of $5-$8 per chlamydia test and a quarterly AF report of chlamydia testing rates for their 16–29 year old patients. The objective of this present study was to examine the effects of removal of these measures on chlamydia testing rates. At the end of the ACCEPt trial, we designed a new 2X2 factorial cluster-RCT. ACCEPt intervention clinics were re-randomised to four arms: remove AF/retain FI, remove FI/retain AF, remove b..