Patient delivered partner therapy for chlamydia infection is used by some general practitioners, but more support is needed to increase uptake: findings from a mixed-methods study

Abstract

ObjectivesPatient-delivered partner therapy (PDPT) describes the giving of a prescription or antibiotics by an index case with chlamydia to their sexual partners. PDPT has been associated with higher numbers of partners receiving treatment. In Australia, general practitioners (GPs) previously expressed negative views about PDPT. Health authority guidance for PDPT has since been provided in some areas. We investigated recent use and perceptions of PDPT for chlamydia among GPs in Australia.MethodsIn 2019, we conducted an online survey comprising multiple-choice and open-ended questions to investigate GPs’ chlamydia management practices, including PDPT. Logistic regression identified factors associated with ever offering PDPT. A directed content analysis of free-text data explored GPs’ perceptions towards PDPT.ResultsThe survey received responses from 323 GPs; 85.8% (n=277) answered PDPT-focused questions, providing 628 free-text comments. Over half (53.4%) reported never offering PDPT, while 36.5% sometimes and 10.1% often offered PDPT. GPs more likely to offer PDPT were aged ≥55 years (adjusted OR (AOR) 2.9, 95% CI 1.4 to 5.8), worked in non-metropolitan areas (AOR 2.5, 95% CI 1.5 to 4.4) and jurisdictions with health authority PDPT guidance (AOR 2.3, 95% CI 1.4 to 3.9). Qualitative data demonstrated that many GPs recognised PDPT’s potential to treat harder to engage partners but expressed hesitancy to offer PDPT because they considered partners attending for care as best practice. GPs emphasised a case-by-case approach that considered patient and partner circumstances to determine PDPT suitability. To alleviate medicolegal concerns, many GPs indicated a need for professional and health authority guidance that PDPT is permissible. They also desired practical resources to support its use.ConclusionGPs appear to accept the place of PDPT as targeted to those who may otherwise not access testing or treatment. Availability of health authority guidance appears to have supported some GPs to incorporate PDPT into their practice.

Management of Chlamydia Cases in Australia (MoCCA): protocol for a non-randomised implementation and feasibility trial

“…Our website was developed in consultation with clinical staff. First, we administered a quantitative survey and conducted interviews with clinical staff to understand chlamydia management practices and inform the website design 21 34 35. Next, we conducted think-aloud interviews36 with clinical staff to assess the usability and acceptability of the prototype website, made modifications to the website and piloted it for 3 months in three practices in NSW and QLD.…”

Community engagement tools in HIV/STI prevention research

“…The integration of peers into community engagement initiatives is often reported with high feasibility and acceptability [21][22][23]. The second type is patient-led interventions, which occurred in the form of patient navigation and patient notification in clinical settings [5,24]. While peer navigation and patient navigation are often used interchangeably in some literature [25,40], peers often refer to who have received some STIrelated or health intervention training and who can reach to a broad population within and beyond clinical settings.…”

Patient-delivered partner therapy: One option for management of sexual partner(s) of a patient diagnosed with a chlamydia infection

“…7 Our recent research with Australian GPs found that they offer PDPT when they feel it is beneficial for their patient, even in the absence of health authority guidance. 16 Participants also reported they would like practical guidance for providing PDPT. 16 In this article, we give an overview of the process of offering PDPT as one option for undertaking partner management for chlamydia, including how to overcome potential challenges in its provision.…”

“…16 Participants also reported they would like practical guidance for providing PDPT. 16 In this article, we give an overview of the process of offering PDPT as one option for undertaking partner management for chlamydia, including how to overcome potential challenges in its provision.…”

“…some challenges with using PDPT. 14,16,18 These challenges, and suggestions for how they can be overcome, include the following. • Recording partner(s) details in the index case's medical record -Documenting information provided by a patient in their medical record complies with standard historytaking practice and is supported by jurisdictional guidelines in some states and territories.…”