Management of Chlamydia Cases in Australia (MoCCA)
Project Details
Management of Chlamydia Cases in Australia (MoCCA) was a National Health and Medical Research Council-funded Partnership Grant (NHMRC) that that sought to address gaps in chlamydia management in Australian general practice. In particular, MoCCA focused on improving testing for repeat infection within recommended timeframes, improving partner management, and increasing clinician confidence in diagnosing pelvic inflammatory disease (PID). MoCCA ran from mid-2018 to the end of 2024.
In the early stages of MoCCA we focused on better understanding the general practice context for chlamydia management. This involved both interviews and surveys with health consumers, general practitioners, and other general practice staff about how chlamydia infections are managed in general practice.
Drawing on these findings, we developed a model of care to support chlamydia management in general practice, which we piloted in general practice clinics in New South Wales and Queensland. The model of care included a website, and other resources and strategies for integrating best practice chlamydia management into routine care. These resources included:
*Shortcuts for entering patient notes into clinician electronic medical records that cover chlamydia management, pelvic inflammatory disease and patient-delivered partner therapy. We also provided instructions for how to import these shortcuts into Best Practice and Medical Director software.
*Patient factsheets for chlamydia and pelvic inflammatory disease
*Resources for patient-delivered partner therapy
*Resources to support retesting
*Continuing professional development (CPD) activities
*Published guidelines for best practice chlamydia management, pelvic inflammatory disease, patient-delivered partner therapy, and shortcuts for use in electronic medical software.
During 2023 to 2024, the MoCCA resources were implemented and evaluated in 14 general practices across New South Wales, Queensland and Victoria in an implementation and feasibility trial. GPs and nurses at participating clinics were asked to use the MoCCA resources to guide their chlamydia and PID diagnosis and management over an up to 12-month intervention period. A range of qualitative and quantitative data were collected and analysed to assess the success of MoCCA’s implementation, its integration into clinical practice and impact on chlamydia management and the patient experience.
We found that the MoCCA resources were mostly simple to set up and use, fit within the general practice setting, and supported improvements in chlamydia management for GPs and nurses. Reported improvements included better quality, continuity and time-efficiency (e.g. website simplified chlamydia management) and patient communication (e.g. shortcuts/factsheets remind to discuss retesting/partners). Many clinicians indicated they would like access to MoCCA resources (particularly the website, shortcuts and factsheets) after the study such as via government or professional organisations with STI-care responsibilities. An increase in retesting was measured between a 12 month pre-intervention period and the intervention period.
Study Findings
The MoCCA Final Report is available here.
You can also view the following study summaries from specific aspects of the study below.
Thank you to all who participated in the project.
Background to the project:
Chlamydia trachomatis (‘chlamydia’) is the most commonly diagnosed bacterial sexually transmitted infection (STI) worldwide and can have serious complications, particularly among people with female reproductive organs.. These include pelvic inflammatory disease (PID) ectopic pregnancy and tubal factor infertility. Repeat infection increases the risk of these complications.
In Australia and internationally there has been a shift in chlamydia control policy from case detection through screening, to strengthening case management in order to reduce chlamydia’s potential adverse reproductive impacts. Given that general practice is where most chlamydia infections are diagnosed and managed in Australia, it is a crucial setting for optimising chlamydia management. The NHMRC funded the MoCCA study to develop and evaluate a model of care for optimising chlamydia case management in Australian general practice. in order to reduce the potential adverse reproductive complications of chlamydia.
The aim of the MoCCA was to reduce the burden of chlamydia infection by scaling up an integrated model of chlamydia case management in general practice. The objectives were:
*Develop and refine an integrated model of chlamydia case management for implementation into Australian general practice.
*Evaluate the clinical uptake and impact of the model.
*Make recommendations for scale-up into general practices across Australia MoCCA focused on addressing key gaps in chlamydia management, namely improving partner management, timely retesting for reinfection and detection of PID.
If you have any questions about the study please email mocca-info@unimelb.edu.au and a member of the research team will get back to you.
Researchers
Chief Investigators:
Professor Rebecca Guy (Kirby Institute)
Professor Christopher Fairley (Melbourne Sexual Health Centre)
Professor Meredith Temple-Smith
A/Prof David Regan (Kirby Institute)
Professor Basil Donovan (Kirby Institute)
Associate Investigators:
Dr Lara Roeske (RACGP)
A/Prof Marcus Chen (Melbourne Sexual Health Centre)
Prof Claudia Estcourt (Glasgow Caledonian University)
Dr David Hawkes (VCS Foundation)
Staff:
Dr Jane Goller, Research Fellow
Dr Jacqueline Coombe, Research Fellow
Helen Bittleston, Research Assistant
Dr Stephanie Munari, PhD candidate
Collaborators
- New South Wales Ministry of Health
- Victorian Government Department of Health
- Queensland Health
- North Western Melbourne Primary Health Network
- Central and Eastern Sydney Primary Health Network
- Sexual Health Victoria (formerly Family Planning Victoria)
- Family Planning NSW
- True Relationships & Reproductive Health
- Australian Centre for the Prevention of Cervical Cancer (formerly VCS Foundation)
- Sydney Sexual Health Centre
Funding
NHMRC Partnership Project (APP1150014)
Research Publications
2025
Munari SC, et al. Facilitators and barriers to adopting a multifaceted chlamydia management intervention in general practice: qualitative findings from Management of Chlamydia Cases in Australia (MoCCA). Australian J Primary Health. 2025. 31(1). doi. 10.1071/PY24179
2024
Warda C, Bittleston H, Coombe J, O’Donnell H, Hocking JS, Goller JL. Patient-delivered partner therapy for chlamydia: health practitioner views on updated guidance in Victoria, Australia. Sexual Health. 2024 Jul; 21, SH24105. https://doi.org/10.1071/SH24105
Munari Stephanie C., Wilkinson Anna L., Asselin Jason, Owen Louise, Read Phillip, Finlayson Robert, Martin Sarah, Bell Charlotte, O’Connor Catherine C., Carter Allison, Guy Rebecca, McNulty Anna, Varma Rick, Chow Eric P. F., Fairley Christopher K., Donovan Basil, Stoove Mark, Goller Jane L., Hocking Jane, Hellard Margaret E., on behalf of the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance of Blood–Borne Viruses and Sexually Transmissible Infections (ACCESS) (2024) Chlamydia retesting remains low among young women in Australia: an observational study using sentinel surveillance data, 2018–2022. Sexual Health 21, SH23178. https://doi.org/10.1071/SH23178
2023
Goller JL, Bittleston H, Munari S, McNamee K, Bateson D, Sanci L, Temple-Smith M, Hocking JS, Coombe J. Streamlining documentation in patient electronic medical records: An example of chlamydia consultation shortcuts. AJGP. 2023 Oct; 53(10). doi: 10.31128/AJGP-01-24-7112
2022
Goller JL, Coombe J, Bittleston H, Bourne C, Bateson D, Vaisey A, Tomnay J, O'Donnell H, Garret C, Estcourt CS, Temple-Smith M, Hocking JS. Patient delivered partner therapy for chlamydia infection is used by some general practitioners, but more support is needed to increase uptake: findings from a mixed-methods study. Sex Transm Infect. 2022 Jun;98(4):298-301. doi: 10.1136/sextrans-2020-054933.
Coombe J, Goller J, Bittleston H, Bateson D, Bourne C, O'Donnell H, Tomnay J, Temple-Smith M, Hocking JS. Patient-delivered partner therapy: One option for management of sexual partner(s) of a patient diagnosed with a chlamydia infection. Aust J Gen Pract. 2022 Jun;51(6):425-429. doi: 10.31128/AJGP-07-21-6066.
Goller J, Bateson D, Williams H, Hocking J. How to treat pelvic inflammatory disease. Australian Doctor. 2022(1 April):17-23. Access to this article requires an Australian Doctor account. Click here to access the article if you already have an Australian Doctor account, or click here to register.
Goller JL, Coombe J, Temple-Smith M, Bittleston H, Sanci L, Guy R, Fairley C, Regan D, Carvalho N, Simpson J, Donovan B, Tomnay J, Chen MY, Estcourt C, Roeske L, Hawkes D, Saville M, Hocking JS. Management of Chlamydia Cases in Australia (MoCCA): protocol for a non-randomised implementation and feasibility trial. BMJ Open 2022;12:e067488. doi: 10.1136/bmjopen-2022-067488
Munari SC, Goller JL, Hellard ME, Hocking JS. Chlamydia prevention and management in Australia: reducing the burden of disease. MJA 2022 Nov;217(10):499-501. https://doi.org/10.5694/mja2.51749
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2021
Coombe, J., Goller, J., Vaisey, A., Bourne, C., Sanci, L., Bateson, D., Temple-Smith, M., Hocking, J., ‘New best practice guidance for general practice to reduce chlamydia associated reproductive complications in women’. Australian Journal of General Practice 2021;50(1-2):50-4. DOI: 10.31128/AJGP-04-20-5330
Layton E, Vaisey A, Goller JL, Coombe J, Temple-Smith M, Hocking J. The views of patients and partners towards patient-delivered partner therapy for chlamydia: A systematic review. Sexually Transmitted Diseases. 2020;47(12):791-7. DOI: 10.1097/OLQ.0000000000001260.
Layton E, Goller JL, Coombe J, Temple-Smith M, Tomnay J, Vaisey A, Hocking, J.S. ‘It’s literally giving them a solution in their hands’: the views of young Australians towards patient-delivered partner therapy for treating chlamydia. Sexually Transmitted Infections. 2021; Online First: 13 January 2021. DOI: http://dx.doi.org/10.1136/sextrans-2020-054820
2020