From the Bureau of Sexually Transmitted Infections.
Division of Disease Control, New York City Department of Health and Mental Hygiene, Long Island City, NY.
Sex Transm Dis. 2020 Jun;47(6):376-382. doi: 10.1097/OLQ.0000000000001163.
Expedited partner therapy (EPT) is commonly provided by prescription; however, the efficacy of this modality is unknown. We examined whether EPT prescriptions are filled when the cost barrier is removed.
To track EPT prescription fill rates, we used single-use pharmacy vouchers that covered the cost of azithromycin, 1 g (chlamydia treatment). We recruited clinical sites to distribute vouchers to patients with chlamydia who would receive an EPT prescription under clinic policies. When distributing vouchers, sites recorded and retained: voucher unique identifier, sex and age of index patient, distribution date, and whether partner name was written on the EPT prescription. Pharmacists receiving vouchers entered the identifier, sex and age of presenting person, and redemption date into a standard pharmacy claim transmission system. Data for redeemed vouchers were retrieved from an industry portal and linked with data retained at clinical sites.
Thirty-two clinical sites distributed 931 vouchers during September 2017 to January 2019; 382 (41%) were redeemed. Vouchers distributed to patients 18 years or younger (49 [30%] of 163) were less likely to be redeemed compared with those distributed to patients older than 18 years (322 [44%] of 736; P = 0.001). Just over half of vouchers were redeemed the same day (196 [56%] of 352) and 1 mile or less from the clinical site (188 [54%] of 349). After excluding an outlier site, vouchers accompanied by EPT prescriptions including a partner name (15 [56%] of 27) were more likely to be redeemed than those lacking a name (83 [34%] of 244; P = 0.03).
Less than half of EPT prescriptions were filled, even when medication was free. Whenever possible, EPT should be provided as drug-in-hand.
加速性伴侣治疗 (EPT) 通常通过处方提供；然而，这种方式的疗效尚不清楚。我们研究了当消除费用障碍时，EPT 处方是否会被开具。
为了跟踪 EPT 处方的配药率，我们使用了一次性药房代金券，涵盖了阿奇霉素 1 克（衣原体治疗）的费用。我们招募了临床地点，向根据诊所政策将获得 EPT 处方的衣原体患者分发代金券。在分发代金券时，各地点记录并保留了：代金券唯一标识符、索引患者的性别和年龄、分发日期以及 EPT 处方上是否写有伴侣的姓名。收到代金券的药剂师将标识符、出示人的性别和年龄以及兑换日期输入到标准的药房索赔传输系统中。从行业门户网站检索已兑换代金券的数据，并与临床地点保留的数据进行链接。
在 2017 年 9 月至 2019 年 1 月期间，32 个临床地点分发了 931 张代金券；382 张（41%）被兑换。分发给 18 岁或以下患者的代金券（163 张中的 49 张[30%]）与分发给 18 岁以上患者的代金券（736 张中的 322 张[44%]）相比，兑换的可能性较小（P = 0.001）。超过一半的代金券在分发当天（352 张中的 196 张[56%]）和距离临床地点 1 英里或以内（349 张中的 188 张[54%]）被兑换。在排除一个异常值地点后，附有 EPT 处方且包含伴侣姓名的代金券（27 张中的 15 张[56%]）比没有姓名的代金券（244 张中的 83 张[34%]）更有可能被兑换（P = 0.03）。
即使药物免费，也只有不到一半的 EPT 处方被开具。只要有可能，EPT 就应该作为随药提供。
