The Views of Patients and Partners Toward Patient-Delivered Partner Therapy for Chlamydia: A Systematic Review

Abstract

Background The majority of research on patient-delivered partner therapy (PDPT) has focused on its impact on reinfections. This study aimed to systematically review the evidence regarding the acceptability of PDPT by patients and partners for chlamydia infection. Methods Three electronic databases were searched in March 2019 using terms related to PDPT. Studies were included if they reported on patient or partner acceptance of PDPT for chlamydia and were conducted in high-income countries. Actual and perceived acceptabilities of PDPT were assessed. Results Thirty-three studies were included: 24 quantitative, 3 qualitative, and 6 mixed methods. Most were clinic based. Quantitative data showed that participants' perceived willingness to give PDPT to their partner(s) ranged from 44.7% to 96.3% (median, 84%), and 24% to 71% (median, 65%) of people who offered PDPT for their partner(s) accepted it. Partners' perceived willingness to accept ranged from 42.7% to 67% (median, 62%), and actual acceptance ranged from 44.7% to 80% (median, 77%). Those in longer-term relationships were generally more likely to accept PDPT; however, beyond this, we identified few clear trends. Qualitative studies found that convenience of PDPT and assurance of partner treatment were benefits, whereas partners not seeing a health care professional was viewed as a downside. Packaging that appeared legitimate and coaching on delivering PDPT were facilitators. Conclusions Because patients bear responsibility for the success of PDPT, this information is crucial in clinical settings. Acceptance, perceived and real, of PDPT was generally high. Patients are best placed to determine whether PDPT is appropriate for them, and it should be offered as an option.

Facilitators and Barriers to Patient-Delivered Partner Therapy Acceptance for Chlamydia trachomatis Among Young African American Men Who Have Sex With Women in a Southern Urban Epicenter

“…Ensuring partners receive treatment is one of the most common reasons why patients accept PDPT. 9 One other study found patients' desire to reduce the spread of Ct in the community to be a motivator for accepting PDPT, 18 and 2 other studies have found that patients described accepting EPT as the responsible thing to do. 19,20 Communication strategies used to help patients accept PDPT could therefore appeal to patients' sense of empathy and collective responsibility.…”

“…Relationship status has been found to influence EPT acceptance in many other studies; patients are consistently more likely to report providing EPT to current romantic partners than ex-or casual partners. 9 Concerns about infidelity have also been previously identified. 23,24 In addition, in their retrospective examination of patient medical records in New York City, Vaidya and colleagues 25 found that patients' belief that their partner had already been treated for Ct was one of the most common reasons why patients refused EPT, with 20.3% making this presumption.…”

“…9 Conversely, patients may not accept EPT/PDPT for their partners if they have concerns about a partner experiencing adverse health effects, apprehension about not getting the prescription or medication directly from a health care provider, or provision is for an ex-partner or casual partner. 9 Despite the emergence of literature on EPT/PDPT acceptance in recent years, there is limited research focused solely on EPT/PDPT among adolescents. 11 Furthermore, to the authors' knowledge, there have been no studies examining PDPT acceptance among young African American men who have sex with women living in the Deep South, 2 groups facing some of the most severe Ct disparities.…”

Safety of Single-Dose Oral Cefixime, Intramuscular Ceftriaxone, or Intramuscular Gentamicin for the Treatment of Gonorrhea: A Systematic Review and Meta-analysis

“…Medications that have a bad "reputation" with respect to painful or unpleasant adverse effects may decrease patient acceptability and adherence to treatment protocols. 9,10 The current recommended treatment for gonorrhea by the Centers for Disease Control and Prevention is a single intramuscular injection of 250 mg ceftriaxone plus a single oral 2-g dose of azithromycin. 6 Oral cefixime is suggested to serve as an alternative to ceftriaxone-another thirdgeneration cephalosporin that provides a more acceptable route for some patients (but only indicated if ceftriaxone is unavailable, because of lower and less sustained bactericidal blood levels).…”

“…Medications that have a bad “reputation” with respect to painful or unpleasant adverse effects may decrease patient acceptability and adherence to treatment protocols. 9,10…”