Emily A Groene1, Christy M Boraas2, M Kumi Smith1, Sarah M Lofgren3, Meghan K Rothenberger3, Eva A Enns4. 1. From the Division of Epidemiology and Community Health, University of Minnesota School of Public Health. 2. Department of Obstetrics, Gynecology and Women's Health, University of Minnesota Medical School. 3. Division of Infectious Disease and International Medicine, University of Minnesota Medical School. 4. School of Public Health, Division of Health Policy and Management, Minneapolis, MN.
Abstract
BACKGROUND: Expedited partner therapy (EPT) refers to the practice of having patients diagnosed with chlamydia or gonorrhea deliver medication directly to their partner(s) to treat them presumptively for infection. Although EPT facilitates timely treatment and prevents reinfection, it remains underused. We used findings from key informant interviews to design and implement a statewide survey to estimate knowledge and utilization of EPT and to identify barriers and facilitators to EPT among Minnesota providers. METHODS: From November to December 2020, we carried out 15 interviews with health providers who currently provide EPT and coded interviews by recurring themes. We then conducted a statewide online survey on sexually transmitted infection treatment and barriers to EPT, from December 2020 to March 2021. We disseminated the survey to all licensed Minnesota health providers, and those who reported treating bacterial sexually transmitted infections in the past year were included in the study. RESULTS: Interview themes included the importance of direct provision of partner medication, administrative/pharmacy barriers to treatment, inclusive EPT eligibility, and patient counseling. Of the 623 health providers who completed the online survey, only 70% thought EPT was legal and only 37% currently offer EPT. Of those who did not provide EPT, 78% said they would under certain circumstances. Barriers included concerns about safety/liability of prescribing without a medical examination, administrative concerns about prescriptions, and patient acceptance. CONCLUSIONS: Given that over a quarter of respondents did not know expedited partner therapy (EPT)'s legal status, improving provider education may increase EPT provision. More research is needed on system-level barriers and patient acceptance of solutions identified in this study.
BACKGROUND: Expedited partner therapy (EPT) refers to the practice of having patients diagnosed with chlamydia or gonorrhea deliver medication directly to their partner(s) to treat them presumptively for infection. Although EPT facilitates timely treatment and prevents reinfection, it remains underused. We used findings from key informant interviews to design and implement a statewide survey to estimate knowledge and utilization of EPT and to identify barriers and facilitators to EPT among Minnesota providers. METHODS: From November to December 2020, we carried out 15 interviews with health providers who currently provide EPT and coded interviews by recurring themes. We then conducted a statewide online survey on sexually transmitted infection treatment and barriers to EPT, from December 2020 to March 2021. We disseminated the survey to all licensed Minnesota health providers, and those who reported treating bacterial sexually transmitted infections in the past year were included in the study. RESULTS: Interview themes included the importance of direct provision of partner medication, administrative/pharmacy barriers to treatment, inclusive EPT eligibility, and patient counseling. Of the 623 health providers who completed the online survey, only 70% thought EPT was legal and only 37% currently offer EPT. Of those who did not provide EPT, 78% said they would under certain circumstances. Barriers included concerns about safety/liability of prescribing without a medical examination, administrative concerns about prescriptions, and patient acceptance. CONCLUSIONS: Given that over a quarter of respondents did not know expedited partner therapy (EPT)'s legal status, improving provider education may increase EPT provision. More research is needed on system-level barriers and patient acceptance of solutions identified in this study.
Authors: Emily R Goggins; Allison T Chamberlain; Tesia G Kim; Marisa R Young; Denise J Jamieson; Lisa B Haddad Journal: Obstet Gynecol Date: 2020-04 Impact factor: 7.661
Authors: Okeoma O Mmeje; Jennifer Z Qin; Marisa K Wetmore; Giselle E Kolenic; Clarissa P Diniz; Jenell S Coleman Journal: Am J Obstet Gynecol Date: 2020-03-02 Impact factor: 8.661
Authors: Janet S St Lawrence; Daniel E Montaño; Danuta Kasprzyk; William R Phillips; Keira Armstrong; Jami S Leichliter Journal: Am J Public Health Date: 2002-11 Impact factor: 9.308
Authors: Julia A Schillinger; Patricia Kissinger; Helene Calvet; William L H Whittington; Ray L Ransom; Maya R Sternberg; Stuart M Berman; Charlotte K Kent; David H Martin; M Kim Oh; H Hunter Handsfield; Gail Bolan; Lauri E Markowitz; J Dennis Fortenberry Journal: Sex Transm Dis Date: 2003-01 Impact factor: 2.830
Authors: Matthew R Golden; Roxanne P Kerani; Mark Stenger; James P Hughes; Mark Aubin; Cheryl Malinski; King K Holmes Journal: PLoS Med Date: 2015-01-15 Impact factor: 11.069
Authors: Sancta St Cyr; Lindley Barbee; Kimberly A Workowski; Laura H Bachmann; Cau Pham; Karen Schlanger; Elizabeth Torrone; Hillard Weinstock; Ellen N Kersh; Phoebe Thorpe Journal: MMWR Morb Mortal Wkly Rep Date: 2020-12-18 Impact factor: 17.586