Okah Ebiere, Arya Vibhuti, Rogers Meighan, Kim Michelle, Schillinger Julia Ann
From the *School of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; †College of Pharmacy and Health Sciences, St John School of Pharmacy, Jersey, NJ; ‡Bureau of Sexually Transmitted Disease Control, New York City Department of Health and Mental Hygiene, New York, NY; and §Division of Sexually Transmitted Disease Prevention, National Center for HIV, Hepatitis, STD, and TB Prevention, United States Centers for Disease Control and Prevention, Atlanta, GA.
Sex Transm Dis. 2017 Feb;44(2):104-108. doi: 10.1097/OLQ.0000000000000551.
Expedited partner therapy (EPT) for Chlamydia trachomatis (Ct) is the practice of providing Ct-infected patients with medication, or prescription (prescription-EPT) to deliver to their sex partners without first examining those partners. New York City (NYC) providers commonly use prescription-EPT, yet NYC pharmacists report only occasional receipt of EPT prescriptions. This project assessed the frequency of EPT prescriptions filled in 2 NYC neighborhoods.
The 2 NYC facilities reporting the most frequent use of prescription-EPT were identified from Ct provider case reports and contacted to ascertain their EPT practices. Providers at the first facility (facility 1) prescribed two 1-g doses of azithromycin, including sex partner treatment on the index patient's electronic prescription. Providers at the second facility (facility 2) gave patients paper prescriptions for sex partners. We reviewed prescriptions filled in 2015 for azithromycin, 1 or 2 g at pharmacies near these facilities; prescriptions indicating partner therapy were classified "EPT prescriptions".
Facility 1 providers submitted 112 Ct case reports indicating prescription-EPT, compared with 114 submitted by facility 2 providers. Twelve of 26 identified pharmacies agreed to participate. At 7 pharmacies near facility 1, we found 61 EPT prescriptions from facility 1 and 37 from other facilities. At 5 pharmacies near facility 2, we found only 1 EPT prescription from facility 2 and 3 from other facilities.
Expedited partner therapy prescriptions were received in NYC pharmacies near to EPT-prescribing facilities, but with great variability and at a lower frequency than suggested by provider case reports. Provider EPT prescribing practices may impact the likelihood that partners receive medication and should be further evaluated.
沙眼衣原体（Ct）的加速性伴侣治疗（EPT）是指在不首先检查性伴侣的情况下，为Ct感染患者提供药物或处方（处方EPT），以便患者将药物递送给其性伴侣。纽约市（NYC）的医疗服务提供者普遍使用处方EPT，但纽约市的药剂师报告称，他们只是偶尔收到EPT处方。本项目评估了纽约市两个社区中EPT处方的开具频率。
从Ct医疗服务提供者的病例报告中确定了纽约市最常使用处方EPT的两家机构，并与他们联系以确定其EPT操作流程。第一家机构（机构1）的医疗服务提供者开具了两剂1克的阿奇霉素，包括在索引患者的电子处方上进行性伴侣治疗。第二家机构（机构2）的医疗服务提供者给患者提供纸质性伴侣处方。我们查阅了2015年在这些机构附近药房开具的1克或2克阿奇霉素的处方；表明伴侣治疗的处方被归类为“EPT处方”。
机构1的医疗服务提供者提交了112份表明处方EPT的Ct病例报告，机构2的医疗服务提供者提交了114份。26家已确定的药房中有12家同意参与。在机构1附近的7家药房，我们发现了来自机构1的61份EPT处方和来自其他机构的37份。在机构2附近的5家药房，我们只发现了来自机构2的1份EPT处方和来自其他机构的3份。
在纽约市靠近开具EPT处方机构的药房中收到了加速性伴侣治疗处方，但差异很大，且频率低于医疗服务提供者病例报告所显示的情况。医疗服务提供者的EPT处方开具操作流程可能会影响性伴侣获得药物的可能性，应进一步评估。
