Niccolai Linda M, Winston Diana M
Yale University School of Medicine, Department of Epidemiology and Public Health and Center for Interdisciplinary Research on AIDS, New Haven, CT 06520-8034, USA.
Am J Prev Med. 2005 Feb;28(2):229-33. doi: 10.1016/j.amepre.2004.10.009.
Patient-delivered therapy (PDT) for nonviral sexually transmitted infections (STIs) is the practice of dispensing or prescribing medication to patients for their sex partners. While this practice is effective in preventing re-infection in patients, its use is not widespread. The purpose of this survey was to assess physicians' PDT practices and opinions toward potential benefits and perceived barriers associated with PDT.
During 2003 and 2004, a random sample of family and general practitioners, internists, emergency medicine physicians, and obstetricians/gynecologists in Connecticut and Rhode Island were mailed surveys and responses were analyzed.
A response rate of 53% was obtained. Approximately 50% of 111 respondents reported having ever used PDT, although a much smaller proportion (6%) reported using it frequently. Potential benefits cited by many physicians included preventing the spread of STI (83%), reinforcing need for partner treatment (78%), and prevention of re-infection in the patient (63%). However, many perceived barriers were also noted, including difficulty ensuring delivery of medication to the partner (96%), concern about adverse reactions in partners (88%), liability (75%), and missed opportunities for other clinical services (68%). Half of all respondents said that they would support legislation to authorize PDT.
The use of PDT is not widespread; physicians recognize the benefits of PDT but many concerns were also noted. A growing body of research indicates that several perceived barriers may be largely unsubstantiated. Therefore, dispelling physician concerns and defining the legal environment surrounding PDT might encourage physicians to use PDT when it is clinically indicated, thereby preventing re-infection in patients and further spread in the community.
针对非病毒性传播感染（STIs）的患者自我给药疗法（PDT）是指为患者的性伴侣分发或开处药物的做法。虽然这种做法在预防患者再次感染方面有效，但其应用并不广泛。本次调查的目的是评估医生的PDT做法以及他们对PDT潜在益处和感知障碍的看法。
在2003年和2004年期间，对康涅狄格州和罗德岛的家庭医生、全科医生、内科医生、急诊医生以及妇产科医生进行随机抽样并邮寄调查问卷，然后对回复进行分析。
获得了53%的回复率。111名受访者中约50%报告曾使用过PDT，不过报告经常使用的比例要小得多（6%）。许多医生提到的潜在益处包括预防性传播感染的传播（83%）、强化伴侣治疗的必要性（78%）以及预防患者再次感染（63%）。然而，也注意到许多感知到的障碍，包括难以确保药物送达伴侣（96%）、担心伴侣出现不良反应（88%）、责任问题（75%）以及错过其他临床服务机会（68%）。所有受访者中有一半表示他们会支持授权PDT的立法。
PDT的使用并不广泛；医生认识到PDT的益处，但也注意到许多问题。越来越多的研究表明，一些感知到的障碍可能在很大程度上没有事实依据。因此，消除医生的顾虑并明确围绕PDT的法律环境可能会鼓励医生在临床有指征时使用PDT，从而预防患者再次感染以及在社区中的进一步传播。
