From the Department of Obstetrics, Gynecology and Reproductive Sciences.
Department of Biostatistics, Yale School of Public Health, New Haven, CT.
Sex Transm Dis. 2024 Jan 1;51(1):15-21. doi: 10.1097/OLQ.0000000000001894. Epub 2023 Oct 30.
Expedited partner therapy prescription remains low and highly variable throughout the United States, leading to frequent reinfections with Chlamydia trachomatis and Neisseria gonorrhoeae . We examined provider counseling on expedited partner therapy before and after an electronic smart tool-based initiative.
In this quasi-experimental interrupted time-series study, we implemented an initiative of electronic smart tools and education for expedited partner therapy in March 2020. We reviewed the records of patients with chlamydia and/or gonorrhea at an urban, academic obstetrics and gynecology clinic in the preimplementation (March 2019-February 2020) and postimplementation (March 2020-February 2021) groups. Descriptive statistics and an interrupted time-series model were used to compare the percent of expedited partner therapy offered by clinicians to patients in each group.
A total of 287 patient encounters were analyzed, 155 preintervention and 132 postintervention. An increase in expedited partner therapy counseling of 13% (95% confidence interval [CI], 2%-24%) was observed before the intervention (27.1% [42 of 155]) versus after the intervention (40.2% [53 of 132]). Significant increases in provider counseling were seen for patients who were single (15%; 95% CI, 3%-26%), 25 years or older (21%; 95% CI, 6%-37%), receiving public insurance (15%; 95% CI, 3%-27%), seen by a registered nurse (18%; 95% CI, 4%-32%), or seen for an obstetrics indication (21%; 95% CI, 4%-39%). No difference was seen in patients' acceptance of expedited partner therapy ( P = 1.00).
A multicomponent initiative focused on electronic smart tools is effective at increasing provider counseling on expedited partner therapy. Further research to understand patient perceptions and acceptance of expedited partner therapy is critical.
在美国,性伴侣加速治疗的处方仍然很低且差异很大,这导致沙眼衣原体和淋病奈瑟菌的频繁再感染。我们研究了在电子智能工具为基础的倡议前后提供者对性伴侣加速治疗的咨询情况。
在这项准实验性的中断时间序列研究中,我们在 2020 年 3 月实施了一项电子智能工具和性伴侣加速治疗教育倡议。我们回顾了一家城市学术妇产科诊所中衣原体和/或淋病患者的记录,在实施前(2019 年 3 月至 2020 年 2 月)和实施后(2020 年 3 月至 2021 年 2 月)组中进行分析。我们使用描述性统计和中断时间序列模型来比较两组中临床医生为患者提供性伴侣加速治疗的比例。
共分析了 287 例患者就诊情况,其中 155 例在干预前,132 例在干预后。干预前,性伴侣加速治疗咨询增加了 13%(95%置信区间 [CI],2%-24%)(27.1%[42/155]),而干预后增加了 40.2%(53/132)。在以下患者中,提供者的咨询显著增加:单身(15%;95%CI,3%-26%)、25 岁或以上(21%;95%CI,6%-37%)、接受公共保险(15%;95%CI,3%-27%)、由注册护士接诊(18%;95%CI,4%-32%)或因产科原因就诊(21%;95%CI,4%-39%)。患者接受性伴侣加速治疗的情况没有差异(P=1.00)。
一项以电子智能工具为重点的多方面倡议能有效提高提供者对性伴侣加速治疗的咨询。进一步研究了解患者对性伴侣加速治疗的看法和接受程度至关重要。