Expedited Partner Therapy: A Multicomponent Initiative to Boost Provider Counseling

Abstract

Background Expedited partner therapy prescription remains low and highly variable throughout the United States, leading to frequent reinfections with Chlamydia trachomatis and Neisseria gonorrhea. We examined provider counseling on expedited partner therapy before and after an electronic smart tools-based initiative. Methods 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 pre-implementation (March 2019-February 2020) and post-implementation (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. Results A total of 287 patient encounters were analyzed, 155 pre-intervention and 132 post-intervention. An increase in expedited partner therapy counseling of 13% (95% CI: 2-24%) was observed pre-intervention (27.1%; 42/155) versus post-intervention (40.2%; 53/132). Significant increases in provider counseling were seen for patients who were single (15%; 95% CI: 3-26%), ≥ 25 years old (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). Conclusions A multi-component 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.