Pharmacy-level barriers in implementing expedited partner therapy in baltimore

Qin, Jennifer Z.; Diniz, Clarissa P.; Coleman, Jo Ann

doi:10.1016/j.ajog.2017.08.076

Cited by 5 publications

(7 citation statements)

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“…Ensuring equal access to the SARS-CoV-2 vaccine is an important part of mitigating structural racism and preventing further propagation of these imbalances. Previous statewide analyses have shown that pharmacy deserts are more likely to be in rural regions with a high white population 20 , while citywide analyses have shown they tend to be located in neighborhoods with more minorities 19,22,23 . Utilizing a 90-minute catchment area to understand vaccine deserts (the definition of which is specific to COVID-19 immunization goals, but more flexible than the strict radius limits routinely used to study access to less scarce resources 19,23 ), our present results are congruent with both these findings.…”

Section: Discussionmentioning

confidence: 99%

“…Studies in Chicago, Baltimore and Los Angeles have shown a higher prevalence of low-access "pharmacy deserts" in minority communities and neighborhoods with higher rates of infectious disease 19,22,23 while a state-wide study in Pennsylvania showed that pharmacy deserts tend to be in rural communities 20 . Scenario modeling suggests these pharmacy disparities may result in unequal distribution of the SARS-CoV-2 vaccine 24 , but to our knowledge no studies have measured geographic accessibility to confirmed vaccine locations or attempted to account for differences in vaccine supply.…”

Section: Introductionmentioning

confidence: 99%

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Spatial Accessibility Modeling of Vaccine Deserts as Barriers to Controlling SARS-CoV-2

Rader

Astley

Sewalk

et al. 2021

Preprint

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SARS-CoV-2 vaccine distribution is at risk of further propagating the inequities of COVID-19, which in the United States (US) has disproportionately impacted the elderly, people of color, and the medically vulnerable. We identify vaccine deserts - US Census tracts with localized, geographic barriers to vaccine-associated herd immunity - using a comprehensive supply database (VaccineFinder) and an empirically parameterized model of spatial access to essential resources. Incorporating high-resolution COVID-19 burden and time-willing-to-travel for vaccination, we show that early (February - March 2021) vaccine allocation disadvantaged rural and medically vulnerable populations. Data-driven vaccine distribution to vaccine deserts may improve immunization in the hesitant and control SARS-CoV-2.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Spatial Accessibility Modeling of Vaccine Deserts as Barriers to Controlling SARS-CoV-2

Rader

Astley

Sewalk

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…Some of the reasons partners may not engage in care include: 1) lack of health insurance; 2) privacy/confidentiality concerns; 3) access to clinical care; and 4) cost or availability of prescription medications. [9][10][11] Economic analysis indicates that expedited partner therapy is a cost-saving and cost-effective STI partner management strategy, specifically amongst adolescents. 12 Several studies have demonstrated that expedited partner therapy is a safe and effective method of preventing persistent or recurrent STIs.…”

Section: Reproductive Health Visitsmentioning

confidence: 99%

Improving Women's Health and Combatting Sexually Transmitted Infections Through Expedited Partner Therapy

Jamison

Coleman

Mmeje

2019

Obstetrics &Amp; Gynecology

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Sexually transmitted infections (STI), including Chlamydia trachomatis and Neisseria gonorrhoeae, have reached record high rates in the United States. Sexually transmitted infections disproportionately affect reproductive-aged women 15 to 44 years old, who account for 65% and 42% of the total reported C. trachomatis and N. gonorrhoeae cases, respectively. Undiagnosed STIs can result in serious health complications that put women at an increased risk for pelvic inflammatory disease, ectopic pregnancy, and tubal factor infertility. Many of these women are seen by physicians (e.g., obstetrician-gynecologists, family medicine doctors, pediatricians) or other clinicians (e.g., nurse practitioners, midwives, physician assistants) who care for women. These clinicians have the opportunity to help curb the continued increase in STI incidence rates with the implementation and use of expedited partner therapy. Expedited partner therapy is a proven effective health care practice that allows clinicians to give patients medications or prescriptions to distribute to their partners. Despite expedited partner therapy's proven effectiveness, there are barriers to its implementation that must be understood in order to enhance STI treatment and prevention efforts. In this commentary, we discuss these barriers, and appeal to women's health clinicians to implement or increase use of expedited partner therapy for the management of women with STIs and their sexual partners.

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“…This finding builds on findings in other studies detailing pharmacy-level barriers to EPT implementation. 16,20 Awareness of EPT's legality remains an issue. 27 We also found that any implementation of EPTwas slightly higher among health providers in general practice settings in our sample, such as outpatient primary care (n = 159, 69%) compared with specialty clinics, such as STI clinics (n = 11, 58%) and family planning clinics and with the exception of community-based clinics, where all providers reported providing EPT (n = 8, 100%).…”

Section: Discussionmentioning

confidence: 99%

“…18 The extent of potential barriers to EPT has not been assessed in a large population-based study of STI treatment provision for providers serving the general public. [19][20][21][22] In this 2-stage mixed methods study, we interviewed providers to understand current EPT implementation, barriers, and potential solutions. We then used interview results to develop an online survey of registered health providers across Minnesota.…”

mentioning

confidence: 99%

A statewide mixed-methods study of provider knowledge and behavior administering Expedited Partner Therapy for chlamydia and gonorrhea

et al. 2022

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Background: Expedited partner therapy (EPT) refers to the practice of having patients diagnosed with chlamydia or gonorrhea deliver medication directly to their partner(s) to treat them presumptively for infection. Although EPT facilitates timely treatment and prevents reinfection, it remains underused. We used findings from key informant interviews to design and implement a statewide survey to estimate knowledge and utilization of EPT and to identify barriers and facilitators to EPT among Minnesota providers.Methods: From November to December 2020, we carried out 15 interviews with health providers who currently provide EPT and coded interviews by recurring themes. We then conducted a statewide online survey on sexually transmitted infection treatment and barriers to EPT, from December 2020 to March 2021. We disseminated the survey to all licensed Minnesota health providers, and those who reported treating bacterial sexually transmitted infections in the past year were included in the study.Results: Interview themes included the importance of direct provision of partner medication, administrative/pharmacy barriers to treatment, inclusive EPT eligibility, and patient counseling. Of the 623 health providers who completed the online survey, only 70% thought EPT was legal and only 37% currently offer EPT. Of those who did not provide EPT, 78% said they would under certain circumstances. Barriers included concerns about safety/liability of prescribing without a medical examination, administrative concerns about prescriptions, and patient acceptance. Conclusions:Given that over a quarter of respondents did not know expedited partner therapy (EPT)'s legal status, improving provider education may increase EPT provision. More research is needed on system-level barriers and patient acceptance of solutions identified in this study.

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Pharmacy-level barriers in implementing expedited partner therapy in baltimore

Cited by 5 publications

References 0 publications

Spatial Accessibility Modeling of Vaccine Deserts as Barriers to Controlling SARS-CoV-2

Spatial Accessibility Modeling of Vaccine Deserts as Barriers to Controlling SARS-CoV-2

Improving Women's Health and Combatting Sexually Transmitted Infections Through Expedited Partner Therapy

A statewide mixed-methods study of provider knowledge and behavior administering Expedited Partner Therapy for chlamydia and gonorrhea

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