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Expedited Partner Therapy The Colorado Experience

Expedited Partner Therapy The Colorado Experience. Cornelis A. Rietmeijer, MD, PhD Denver Public Health Department. Expedited Partner Therapy. Approach whereby partners are treated without an intervening clinical assessment Patients delivering medications to partners

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Expedited Partner Therapy The Colorado Experience

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  1. Expedited Partner TherapyThe Colorado Experience Cornelis A. Rietmeijer, MD, PhD Denver Public Health Department

  2. Expedited Partner Therapy • Approach whereby partners are treated without an intervening clinical assessment • Patients delivering medications to partners • Patients delivering prescriptions to partners • Field treatment by DIS or outreach workers (with or without testing)

  3. EPT Studies • Schillinger et al. Sex Transm Dis 2003;30:49-56 • 20% reduction in CT re-infection of 20% among women (P = 0.102) • Golden et al. New Engl J Med 2005;352:676-85 • 73% reduction in GC re-infection among men and women (P < 0.01) • 17% reduction in CT re-infection (P = 0.17) • Kissinger et al. Clin Infect Dis 2005; 41:623-9 • 46% reduction in GC and/or CT infection among men with urethritis (P<0.001)

  4. EPT and the CDC 2006 STD Treatment Guidelines • “….patient delivered therapy (i.e., via medications or prescriptions) can prevent re-infection of index case and has been associated with a higher likelihood of partner notification, compared with unassisted patient referral of partners” • EPT recommendations are limited to GC and CT contacts only • EPT is not recommended for MSM

  5. In Colorado, EPT has been endorsed by the state’s medical and pharmacy boards

  6. EPT in Colorado http://www.dora.state.co.us/Medical/policies/40-10.pdf

  7. EPT in Colorado www.dora.state.co.us/pharmacy/policies/40-4.pdf

  8. EPT in the Denver STD Clinic • Between 11/9/2006 and 2/28/2007 • 223 heterosexual patients with document GC or CT eligible for EPT • 46 (20.6%) received EPT • Median: 1 Range: 1-3 • No demographic or risk differences between those who did or did not accept EPT

  9. Partner Pack Chlamydia

  10. EPT in the Denver STD Clinic • Main reasons for not receiving EPT • Partners already treated or in clinic concurrently (48.1%) • Patients preferred partners come to the clinic (25.3%) • No contact info (17.5%) • Among clinicians, provision of EPT varied from 5% to 45%

  11. EPT Resources http://www.cdc.gov/std/ept/

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