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患者递呈性伴侣治疗衣原体感染:澳大利亚维多利亚州卫生从业者对最新指南的看法。

Patient-delivered partner therapy for chlamydia: health practitioner views on updated guidance in Victoria, Australia.

机构信息

Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic, Australia.

Department of Health, Victoria, Melbourne, Vic, Australia.

出版信息

Sex Health. 2024 Jul;21. doi: 10.1071/SH24105.

DOI:10.1071/SH24105
PMID:39074237
Abstract

Background Patient-delivered partner therapy (PDPT) involves providing a prescription or medication to a patient diagnosed with chlamydia to pass to their sexual partner/s. Barriers to PDPT include uncertainty about its integration into clinical practice and permissibility. In Victoria, Australia, the Department of Health provides clinical guidance for PDPT (updated in 2022). We explored health practitioner views on the usefulness of the updated guidance for providing PDPT. Methods We conducted an online survey (12 December 2022 to 2 May 2023) of health practitioners who primarily work in Victoria and can prescribe to treat chlamydia. The survey displayed excerpts from the guidance, and asked closed and free-text questions about its ability to address barriers to PDPT. Quantitative data were descriptively analysed, complemented by conventional content analysis of qualitative data. Results Of a total of 49 respondents (66.7% general practitioners), 74.5% were aware of PDPT, and 66.7% had previously offered PDPT. After viewing excerpts of the guidance, >80% agreed it could support them to identify patients eligible/ineligible for PDPT, and 66.7% indicated they would be comfortable to offer PDPT. The guidance was viewed as helpful to address some barriers, including complicated documentation (87.7%) and medico-legal concerns (66.7%). Qualitative data highlighted medico-legal concerns by a minority of respondents. Some raised concerns that the guidance recommended prescribing azithromycin, despite doxycycline being first-line chlamydia treatment. Conclusions The guidance was largely viewed as supportive for PDPT decision-making. There is scope for further refinements and clarifications, and wider dissemination of the guidance.

摘要

背景 患者递药伴侣治疗(PDPT)涉及将处方或药物提供给诊断出衣原体感染的患者,以便其转交给性伴侣。PDPT 的障碍包括对其纳入临床实践的不确定性和可接受性。在澳大利亚维多利亚州,卫生部为 PDPT 提供临床指导(2022 年更新)。我们探讨了卫生保健从业者对更新后的指导在提供 PDPT 方面的有用性的看法。

方法 我们对主要在维多利亚州工作且可以开处方治疗衣原体感染的卫生保健从业者进行了一项在线调查(2022 年 12 月 12 日至 2023 年 5 月 2 日)。调查显示了指导的摘录,并询问了有关其解决 PDPT 障碍能力的封闭和自由文本问题。定量数据进行了描述性分析,定性数据则进行了传统的内容分析。

结果 在总共 49 名受访者(66.7%为全科医生)中,74.5%知晓 PDPT,66.7%曾提供过 PDPT。在查看了指导的摘录后,超过 80%的人认为它可以帮助他们确定患者是否有资格接受/不接受 PDPT,66.7%的人表示他们愿意提供 PDPT。该指导被认为有助于解决一些障碍,包括复杂的文件记录(87.7%)和医学法律问题(66.7%)。少数受访者的定性数据突出了医学法律问题。一些人担心该指导建议开阿奇霉素处方,尽管多西环素是治疗衣原体的一线药物。

结论 该指导在很大程度上支持 PDPT 的决策制定。该指导有进一步改进和澄清的空间,并且需要更广泛地传播该指导。

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