Groene Emily A, Boraas Christy M, Smith M Kumi, Lofgren Sarah M, Rothenberger Meghan K, Enns Eva A
Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA.
Department of Obstetrics, Gynecology and Women's Health, University of Minnesota Medical School, Minneapolis, MN, USA.
MDM Policy Pract. 2023 Jan 22;8(1):23814683221150446. doi: 10.1177/23814683221150446. eCollection 2023 Jan-Jun.
Despite the established effectiveness of expedited partner therapy (EPT) in partner treatment of bacterial sexually transmitted infections (STI), the practice is underutilized. To estimate the relative effectiveness of strategies to increase EPT uptake (numbers of partners treated for chlamydia). We developed a care cascade model of cumulative probabilities to estimate the number of partners treated under strategies to increase EPT uptake in Minnesota. The care cascade model used data from clinical trials, population-based studies, and Minnesota chlamydia surveillance as well as in-depth interviews of health providers who regularly treat STI patients and a statewide survey of health providers across Minnesota. Several strategies could improve EPT uptake among providers, including facilitating treatment payment (additional 1,932 partners treated) and implementing electronic health record reminders (additional 1,755 partners treated). Addressing concerns about liability would have the greatest effect, resulting in 2,187 additional partners treated. Providers expressed openness to offering EPT under several scenarios, which reflect differences in knowledge about EPT, its legality, and potential risks to patients. While addressing concerns about provider liability would have the greatest effect on number of partners treated, provider education and procedural changes could make a substantial impact.
Addressing provider concerns about expedited partner therapy (EPT) legality and its potential risks would result in the most partners treated for chlamydia.EPT alerts and electronic EPT prescriptions may also streamline partner treatment.Provider education about the legality of EPT and its potential risks and training in counseling patients on EPT could also increase uptake.
尽管快速性伴治疗（EPT）在细菌性性传播感染（STI）的性伴治疗中已证实有效，但该方法的应用仍未得到充分利用。为了评估提高EPT使用率（衣原体感染性伴接受治疗的人数）的策略的相对有效性。我们开发了一个累积概率的治疗级联模型，以估计明尼苏达州提高EPT使用率的策略下接受治疗的性伴人数。该治疗级联模型使用了来自临床试验、基于人群的研究、明尼苏达州衣原体监测的数据，以及对定期治疗STI患者的医疗服务提供者的深入访谈和对明尼苏达州医疗服务提供者的全州范围调查。有几种策略可以提高医疗服务提供者对EPT的使用率，包括促进治疗费用支付（额外治疗1932名性伴）和实施电子健康记录提醒（额外治疗1755名性伴）。解决对责任的担忧将产生最大影响，导致额外治疗2187名性伴。医疗服务提供者表示愿意在几种情况下提供EPT，这反映了他们对EPT的了解、其合法性以及对患者潜在风险方面的差异。虽然解决对医疗服务提供者责任的担忧对接受治疗的性伴人数影响最大，但医疗服务提供者教育和程序改变也可能产生重大影响。
解决医疗服务提供者对快速性伴治疗（EPT）合法性及其潜在风险的担忧将导致接受衣原体治疗的性伴最多。EPT警报和电子EPT处方也可能简化性伴治疗。对医疗服务提供者进行EPT合法性及其潜在风险的教育以及在为患者提供EPT咨询方面的培训也可以提高使用率。
