为在初级保健中被诊断为沙眼衣原体感染的患者开发并测试用于性伴通知的加速性伴治疗：一项试点随机对照试验。
Developing and testing accelerated partner therapy for partner notification for people with genital Chlamydia trachomatis diagnosed in primary care: a pilot randomised controlled trial.
作者信息
Estcourt Claudia S, Sutcliffe Lorna J, Copas Andrew, Mercer Catherine H, Roberts Tracy E, Jackson Louise J, Symonds Merle, Tickle Laura, Muniina Pamela, Rait Greta, Johnson Anne M, Aderogba Kazeem, Creighton Sarah, Cassell Jackie A
机构信息
Blizard Institute, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK.
Research Department of Infection & Population Health, University College London, London, UK.
出版信息
Sex Transm Infect. 2015 Dec;91(8):548-54. doi: 10.1136/sextrans-2014-051994. Epub 2015 May 27.
BACKGROUND
Accelerated partner therapy (APT) is a promising partner notification (PN) intervention in specialist sexual health clinic attenders. To address its applicability in primary care, we undertook a pilot randomised controlled trial (RCT) of two APT models in community settings.
METHODS
Three-arm pilot RCT of two adjunct APT interventions: APTHotline (telephone assessment of partner(s) plus standard PN) and APTPharmacy (community pharmacist assessment of partner(s) plus routine PN), versus standard PN alone (patient referral). Index patients were women diagnosed with genital chlamydia in 12 general practices and three community contraception and sexual health (CASH) services in London and south coast of England, randomised between 1 September 2011 and 31 July 2013.
RESULTS
199 women described 339 male partners, of whom 313 were reported by the index as contactable. The proportions of contactable partners considered treated within 6 weeks of index diagnosis were APTHotline 39/111 (35%), APTPharmacy 46/100 (46%), standard patient referral 46/102 (45%). Among treated partners, 8/39 (21%) in APTHotline arm were treated via hotline and 14/46 (30%) in APTPharmacy arm were treated via pharmacy.
CONCLUSIONS
The two novel primary care APT models were acceptable, feasible, compliant with regulations and capable of achieving acceptable outcomes within a pilot RCT but intervention uptake was low. Although addition of these interventions to standard PN did not result in a difference between arms, overall PN uptake was higher than previously reported in similar settings, probably as a result of introducing a formal evaluation. Recruitment to an individually randomised trial proved challenging and full evaluation will likely require service-level randomisation.
TRIAL REGISTRATION NUMBER
Registered UK Clinical Research Network Study Portfolio id number 10123.
背景
加速性伴侣治疗（APT）是一种针对专科性健康诊所就诊者的、很有前景的性伴侣通知（PN）干预措施。为了探讨其在初级保健中的适用性，我们在社区环境中对两种APT模式进行了一项试点随机对照试验（RCT）。
方法
对两种辅助性APT干预措施进行三臂试点RCT：APTHotline（对性伴侣进行电话评估加标准PN）和APTPharmacy（社区药剂师对性伴侣进行评估加常规PN），与单独的标准PN（患者转诊）进行对比。索引患者为在伦敦和英格兰南海岸的12家普通诊所以及3家社区避孕与性健康（CASH）服务机构中被诊断为生殖系统衣原体感染的女性，于2011年9月1日至2013年7月31日期间进行随机分组。
结果
199名女性描述了339名男性伴侣，其中索引患者报告有313名伴侣可联系。在索引诊断后的6周内，被认为已接受治疗的可联系伴侣比例分别为：APTHotline组39/111（35%），APTPharmacy组46/100（46%），标准患者转诊组46/102（45%）。在接受治疗的伴侣中，APTHotline组有8/39（21%）通过热线接受治疗，APTPharmacy组有14/46（30%）通过药房接受治疗。
结论
这两种新型初级保健APT模式是可接受的、可行的，符合规定，并且在试点RCT中能够取得可接受的结果，但干预措施的采用率较低。虽然在标准PN基础上增加这些干预措施并未导致各臂之间出现差异，但总体PN采用率高于此前在类似环境中的报告水平，这可能是引入正式评估的结果。事实证明，招募个体随机试验具有挑战性，全面评估可能需要服务层面的随机化。
试验注册号
英国临床研究网络研究组合识别号10123 。
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