Centre for Epidemiology and Biostatistics, The University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
Centre for Epidemiology and Biostatistics, The University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia.
Sex Transm Infect. 2022 Jun;98(4):298-301. doi: 10.1136/sextrans-2020-054933. Epub 2021 Jun 30.
Patient-delivered partner therapy (PDPT) describes the giving of a prescription or antibiotics by an index case with chlamydia to their sexual partners. PDPT has been associated with higher numbers of partners receiving treatment. In Australia, general practitioners (GPs) previously expressed negative views about PDPT. Health authority guidance for PDPT has since been provided in some areas. We investigated recent use and perceptions of PDPT for chlamydia among GPs in Australia.
In 2019, we conducted an online survey comprising multiple-choice and open-ended questions to investigate GPs' chlamydia management practices, including PDPT. Logistic regression identified factors associated with ever offering PDPT. A directed content analysis of free-text data explored GPs' perceptions towards PDPT.
The survey received responses from 323 GPs; 85.8% (n=277) answered PDPT-focused questions, providing 628 free-text comments. Over half (53.4%) reported never offering PDPT, while 36.5% sometimes and 10.1% often offered PDPT. GPs more likely to offer PDPT were aged ≥55 years (adjusted OR (AOR) 2.9, 95% CI 1.4 to 5.8), worked in non-metropolitan areas (AOR 2.5, 95% CI 1.5 to 4.4) and jurisdictions with health authority PDPT guidance (AOR 2.3, 95% CI 1.4 to 3.9). Qualitative data demonstrated that many GPs recognised PDPT's potential to treat harder to engage partners but expressed hesitancy to offer PDPT because they considered partners attending for care as best practice. GPs emphasised a case-by-case approach that considered patient and partner circumstances to determine PDPT suitability. To alleviate medicolegal concerns, many GPs indicated a need for professional and health authority guidance that PDPT is permissible. They also desired practical resources to support its use.
GPs appear to accept the place of PDPT as targeted to those who may otherwise not access testing or treatment. Availability of health authority guidance appears to have supported some GPs to incorporate PDPT into their practice.
患者递药治疗（PDPT）是指衣原体感染的患者将处方或抗生素给性伴侣使用。PDPT 与更多的伴侣接受治疗有关。在澳大利亚，全科医生（GP）此前对 PDPT 持负面看法。此后，一些地区提供了 PDPT 的卫生当局指南。我们调查了澳大利亚全科医生最近对衣原体患者递药治疗的使用情况和看法。
在 2019 年，我们进行了一项在线调查，包括多项选择题和开放式问题，以调查全科医生的衣原体管理实践，包括 PDPT。逻辑回归确定了与提供 PDPT 相关的因素。对自由文本数据进行定向内容分析，探讨了全科医生对 PDPT 的看法。
该调查收到了 323 名全科医生的回复；85.8%（n=277）回答了以 PDPT 为重点的问题，提供了 628 条自由文本评论。超过一半（53.4%）的医生表示从未提供过 PDPT，而 36.5%的医生有时提供，10.1%的医生经常提供。更有可能提供 PDPT 的全科医生年龄≥55 岁（调整后的比值比（AOR）2.9，95%置信区间 1.4 至 5.8），在非大都会地区工作（AOR 2.5，95%置信区间 1.5 至 4.4）和有卫生当局 PDPT 指南的司法管辖区（AOR 2.3，95%置信区间 1.4 至 3.9）。定性数据表明，许多全科医生认识到 PDPT 有潜力治疗更难接触的伴侣，但他们对提供 PDPT 犹豫不决，因为他们认为前来护理的伴侣是最佳做法。全科医生强调了一种个案处理的方法，即根据患者和伴侣的情况来确定 PDPT 的适用性。为了减轻法律方面的担忧，许多全科医生表示需要专业和卫生当局的指导，以允许进行 PDPT。他们还希望获得支持其使用的实用资源。
全科医生似乎接受了 PDPT 的地位，认为 PDPT 适用于那些可能无法接受检测或治疗的患者。卫生当局指南的提供似乎支持了一些全科医生将 PDPT 纳入其实践。
