Is Accelerated Partner Therapy (APT) a cost-effective alternative to routine patient referral partner notification in the UK? Preliminary cost–consequence analysis of an exploratory trial

Roberts, Tracy; Tsourapas, A; Sutcliffe, L; Cassell, Jackie A; Estcourt, Claudia

doi:10.1136/sextrans-2011-050176

Cited by 11 publications

(21 citation statements)

References 8 publications

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“…80 In addition to the duration of the consultation, we allowed an additional 10 minutes for the equivalent of a practice nurse to carry out administrative tasks such as registering patients, based on reported trial practice and to be consistent with the findings of a previous study. 96 …”

Section: Aptpharmacymentioning

confidence: 99%

“…96 We also included costs associated with the purchase of a mobile phone and credit. We assumed that the phone unit could be reused for a period of 3 years and discounted costs accordingly (at an interest rate of 3%).…”

Section: Apthotlinementioning

confidence: 99%

“…The estimated cost of a consultation in ClaSS was £34.55 (in 2004/5 prices). Following the methods used to evaluate APT in a specialist care setting, 96 we subtracted the cost of treatment with azithromycin (£12.71) and the cost of a urine test (£4.47) from the ClaSS routine cost, resulting in a cost of £17.37 (in 2004/5 prices). We inflated this cost to 2012/13 prices giving a result of £21.62.…”

Section: Standard Partner Notificationmentioning

confidence: 99%

“…49,96,102 As part of ClaSS, primary resource use and cost data associated with chlamydia testing and partner notification in a primary care and GUM setting were collected. We assumed that the process described in ClaSS was similar to standard partner treatment for the APT trial.…”

Section: Standard Partner Notificationmentioning

confidence: 99%

“…95 These meet UK prescribing guidance and have shown promise in the specialist setting. 95,96 Furthermore, modelling studies suggest that APT could play an important role in reducing index reinfection and the prevention of costly reproductive health consequences, especially in women, 93,94 by reducing the time to successful partner treatment. 95 Successful control of chlamydia will need effective methods of partner notification, irrespective of the setting in which the infection is diagnosed.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

The Ballseye programme: a mixed-methods programme of research in traditional sexual health and alternative community settings to improve the sexual health of men in the UK

Estcourt

Sutcliffe

Mercer

et al. 2016

Programme Grants Appl Res

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is governor of the Wellcome Trust. Jackie Cassell reports funding from the NIHR HTA programme as principal investigator for the study 'The relative clinical effectiveness and cost-effectiveness of three contrasting approaches to partner notification for curable sexually transmitted infections: a cluster randomised trial in primary care' (reference number 07/43/01), for which the final report has been published [Cassell JA, Dodds J, Estcourt C, Llewellyn C, Lanza S, Richens J, et al. The relative clinical effectiveness and cost-effectiveness of three contrasting approaches to partner notification for curable sexually transmitted infections: a cluster randomised trial in primary care. This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full PGfAR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/pgfar. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Programme Grants for Applied Research journalReports are published in Programme Grants for Applied Research (PGfAR) if (1) they have resulted from work for the PGfAR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. Programme Grants for Applied Research programmeThe Programme Grants for Applied Research (PGfAR) programme, part of the National Institute for Health Research (NIHR), was set up in 2006 to produce independent research findings that will have practical application for the benefit of patients and the NHS in the relatively near future. The Programme is managed by the NIHR Central Commissioning Facility (CCF) with strategic input from the Programme Director.The programme is a national response mode funding scheme that aims to provide evidence to improve health outcomes in England through promotion of health, prevention of ill health, and optimal disease management (including safety and quality), with particular emphasis on conditions causing significant disease burden.For more information about the PGfAR programme please visit the website: http://www.nihr.ac.uk/funding/programme-grants-forapplied-research.htm This reportThe research reported in this issue of the journal was funded by PGfAR as project number RP-PG-0707-10208. The contractual start date was in February 2009. The final report began editorial review in May 2015 and was accepted for publication in December 2015. As the funder, the PGfAR programme agreed the research questions and study designs in advance with the investigators. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The PGfAR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept...

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Section: Aptpharmacymentioning

confidence: 99%

Section: Apthotlinementioning

confidence: 99%

Section: Standard Partner Notificationmentioning

confidence: 99%

Section: Standard Partner Notificationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The Ballseye programme: a mixed-methods programme of research in traditional sexual health and alternative community settings to improve the sexual health of men in the UK

Estcourt

Sutcliffe

Mercer

et al. 2016

Programme Grants Appl Res

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Investigating the effects of accelerated partner therapy (APT) on chlamydia transmission in Britain: a mathematical modelling study

Althaus

Mercer

Cassell

et al. 2020

Preprint

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Understanding the effects of partner notification (PN) on the transmission of chlamydia, the most prevalent bacterial sexual transmitted infection worldwide, is critical for implementing optimal control strategies. Accelerated partner therapy (APT) aims to increase the numbers of partners treated and reduce the time to partner treatment. Our objective was to study the effects of APT interventions on partner treatment and chlamydia transmission in order to better understand the results of LUSTRUM, an APT cross-over cluster randomised controlled trial in the UK. We developed a novel deterministic, population-based chlamydia transmission model including the process of PN. We considered a population aged 16-34 years and calibrated the model to sexual behaviour data between people of the opposite-sex and chlamydia prevalence data reported by 3,671 participants in Britain's third National Survey of Sexual Attitudes and Lifestyles (Natsal-3, 2010-2012) using Approximate Bayesian Computation (ABC). We investigated the potential effects of APT on chlamydia transmission by increasing the number of treated partners and reducing the time to partner treatment compared to standard PN. The median prevalence of chlamydia in the model was 1.84% (95% credible interval, CrI: 1.60%-2.62%) in women and 1.78% (95% CrI: 1.13%-2.14%) in men. Chlamydia positivity was highest in partners of symptomatic index cases with low sexual activity. Infected partners were typically asymptomatic and belonged to the high sexual activity group, i.e., are naturally those infected individuals that will contribute most to onward transmission. Reducing the time to partner treatment without achieving higher numbers of partners treated had only minor effects on reducing chlamydia prevalence. In contrast, the model predicts that a potential increase in the number of partners treated from current levels in Britain (0.51, 95% CrI: 0.21-0.80) by 25% would reduce chlamydia prevalence by 18% (95% CrI: 5%-44%) in both women in men within 5 years. These results suggest that APT, through a potential increase in the proportion of partners treated, would be an effective method to reduce ongoing chlamydia transmission in Britain.

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The cost-effectiveness of accelerated partner therapy (APT) compared to standard contact tracing for people with chlamydia: an economic evaluation based on the LUSTRUM population-based chlamydia transmission model

Williams

Okeke

Estcourt

et al. 2021

Preprint

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Objective: To investigate the cost-effectiveness of accelerated partner therapy (APT) compared with standard contact tracing for people with sexually transmitted chlamydia infection in the United Kingdom Design: Economic evaluation using a model consisting of two components: a population-based chlamydia transmission component, to estimate the impact of APT on chlamydia prevalence, and an economic component, to estimate the impact of APT on healthcare costs and health outcomes. Setting: United Kingdom Participants: Hypothetical heterosexual population of 50,000 men and 50,000 women aged 16-34 years. Main Outcome Measures: Cost-effectiveness based on quality-adjusted life years (QALYs) gained and major outcomes averted (MOA), defined as mild pelvic inflammatory disease (PID), severe PID, chronic pelvic pain, ectopic pregnancy, tubal factor infertility and epididymitis. Results: For a model population of 50,000 men and 50,000 women and an APT intervention lasting 5 years, the intervention cost of APT (&pound135,201) is greater than the intervention cost of standard contact tracing (&pound116,334). When the costs of complications arising from chlamydia are considered, the total cost of APT (&pound370,657) is lower than standard contact tracing (&pound379,597). Thus, APT yields a total cost saving of approximately &pound9000 and leads to 73 fewer major outcomes and 21 fewer QALYs lost. Hence, APT is the dominant PN strategy. APT remained cost-effective across the full range of sensitivity analyses. Conclusions: Based on cost-effectiveness grounds APT is likely to be recommended as an alternative to standard contact tracing for chlamydia infection in the United Kingdom

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Is Accelerated Partner Therapy (APT) a cost-effective alternative to routine patient referral partner notification in the UK? Preliminary cost–consequence analysis of an exploratory trial

Cited by 11 publications

References 8 publications

The Ballseye programme: a mixed-methods programme of research in traditional sexual health and alternative community settings to improve the sexual health of men in the UK

The Ballseye programme: a mixed-methods programme of research in traditional sexual health and alternative community settings to improve the sexual health of men in the UK

Investigating the effects of accelerated partner therapy (APT) on chlamydia transmission in Britain: a mathematical modelling study

The cost-effectiveness of accelerated partner therapy (APT) compared to standard contact tracing for people with chlamydia: an economic evaluation based on the LUSTRUM population-based chlamydia transmission model

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