Implementation and effectiveness of an expedited partner therapy program in an urban clinic.
Abstract
BACKGROUND: Partner notification of exposure to gonorrhea or chlamydia is traditionally conducted by the index case or a disease intervention specialist. However, a significant proportion of partners remain untreated and thus are at risk for continued transmission. Expedited partner therapy (EPT) obviates the requirement for a health care visit by the partner: the index case delivers medications to the partner. Although shown to be efficacious in randomized control trials, effectiveness studies of delivering EPT in real-world situations are needed. We describe the implementation, patient characteristics, and clinical impact of an EPT program at the Denver Metro Health Clinic (DMHC). METHODS: We identified 2578 patient visits eligible for EPT (heterosexual men or women diagnosed as having chlamydia or gonorrhea) from November, 2006, to April, 2011. We examined EPT acceptance rates over clinical process improvements. To measure clinical impact, we assessed the association between initial acceptance of EPT and infection status among 351 patients who returned for retesting. RESULTS: Requiring complete documentation of EPT in the clinic electronic medical record increased EPT acceptance from 20% to 48%. Expedited partner therapy acceptance was associated with a reduced risk of chlamydial reinfection (odds ratio, 0.7; 95% confidence interval, 0.3-1.6) and a reduced risk of gonorrheal reinfection (odds ratio, 0.5; 95% confidence interval, 0.2-1.4); however, these changes were not statistically significant. CONCLUSIONS: Expedited partner therapy at the DMHC was substantially enhanced by process changes in the clinic and may be associated with a decreased risk of reinfection.
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Concurrent treatment of a main sex partner can be effective.
“Although this approach can be effective for a main partner (116,117), it might not be a feasible approach for additional sex partners.”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [117]
Cites
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Racial disparities in access to reproductive health and fertility care in the United States
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- Authors
- Mickiewicz, T., Al-Tayyib, A., Thrun, M., & Rietmeijer, C.
- Affiliations
- Denver Health Medical Center (US)
- Corresponding author
- Mickiewicz, Theresa
- Thrun, Mark
- Rietmeijer, Cornelis
- Venue
- Sexually Transmitted Diseases
- Published
- 2012-12
- Volume
- 39
- Issue
- 12
- Pages
- 923-929
- ISSN
- 0148-5717 (ISSN-L)
- OpenAlex
- W2038405530
- Cited by
- 26
- References
- 9
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 4 · 2020: 1 · 2019: 1 · 2017: 2 · 2016: 3 · 2015: 5 · 2014: 2 · 2013: 2
- FWCI
- 2.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sexually Transmitted Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- expedited partner therapy, chlamydia, gonorrhea, partner notification, reinfection, electronic health record documentation, sexually transmitted infections, urban clinics
- MeSH terms
- Adolescent, Adult, Chlamydia Infections, Colorado, Female, Gonorrhea, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Sexual Partners, Urban Population, Contact Tracing, Guidelines as Topic, Heterosexuality, Young Adult
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