Facilitators and Barriers to Expedited Partner Therapy: Results From a Survey of Family Physicians

Abstract

Background Expedited partner therapy (EPT) can prevent transmission of sexually transmitted infections (STIs) and reinfection of the index patient. We surveyed family physicians (FPs) in British Columbia to understand their perceptions of barriers and facilitators to EPT use and explored how perceptions varied by demographic and practice characteristics. Methods Survey participants were recruited through the Divisions of Family Practice, which include greater than 90% of FPs in British Columbia. Common barriers and facilitators for EPT were identified using descriptive statistics. The association between each EPT barrier and facilitator and demographic and practice characteristics were tested using χ2 test. Results One hundred eighty-one FPs started the survey, of which 146 (80.7%) answered 10 questions or more and were analyzed. Overall, inaccurate information about sex partners (88 [60.3%] of 146) and medicolegal concerns (87 [59.6%] of 146) were the most common barriers reported. Family physicians in nonurban settings were more likely to identify insufficient time as a barrier compared with FPs in urban settings (P < 0.01). The most common facilitators were having a health care professional for follow-up after prescribing EPT (110 [75.3%] of 146), improved remuneration (93 [63.7%] of 146), clear clinical guidelines around EPT (87/146, 59.6%), and having a legal framework (92 [63.0%] of 146). Family physicians practicing for less than 9 years (the median) were more likely to identify the latter as facilitating EPT compared with FPs practicing for 9 years or longer (P < 0.05). Conclusions Ensuring patients have access to a health care professional for follow-up, improved remuneration, and development of clinical guidelines and a legal framework can support the implementation of EPT. Tools catered to different practice types and contexts may help increase EPT use.

Mixed-methods Evaluation of an Expedited Partner Therapy Take-home Medication Program: Pilot Emergency Department Intervention to Improve Sexual Health Equity

“…An independently generated, semi-structured interview guide was prepared using elements from the Consolidated Framework for Implementation Research (CFIR) 21 and published manuscripts on EPT implementation. 22 – 24 There is currently no validated interview guide related to EPT. The interview guide was pilot-tested and iteratively revised with three clinicians unaffiliated with this project by conducting cognitive-based assessments using the “think-aloud” 25 approach to ensure comprehension and fidelity to the question intent ( Appendix 1 ).…”

Mixed-method evaluation of an expedited partner therapy take-home medication program: a pilot ED intervention to improve sexual health equity

“…An independently generated, semi-structured interview guide was prepared using elements from the Consolidated Framework for Implementation Research (CFIR) 21 and published manuscripts on EPT implementation. [22][23][24] There is currently no validated interview guide related to EPT. The interview guide was pilot-tested and iteratively revised with three clinicians unaffiliated with this project by conducting cognitive-based assessments using the 'think-aloud' 25 approach to ensure comprehension and fidelity to the question intent (Appendix 3).…”

Expedited Partner Therapy at US College Health Centers: Update and Recommendations for Improved Uptake and Measurement

“…More research is also needed on facilitators and barriers to EPT uptake specific to CHC professionals. This literature exists among health care providers broadly and within specific medical specialties 22,23 ; it is unclear if there are differences among college health practitioners. Additional research is also needed to better understand the actuality of EPT provision for STIs outside of chlamydia and gonorrhea at CHCs.…”