Partner notification and partner treatment for chlamydia: attitude and practice of general practitioners in the Netherlands; a landscape analysis

BMC Family Practice

Research Article

Birgit H. B. van Benthem¹  Ingrid V. F. van den Broek¹  Jan E. A. M. van Bergen²  Hannelore M. Götz³  Gé A. Donker⁴  Karin Hek⁵ 

[1] Epidemiology and Surveillance Unit, Centre for Infectious Diseases Control, RIVM, Bilthoven, The Netherlands;Epidemiology and Surveillance Unit, Centre for Infectious Diseases Control, RIVM, Bilthoven, The Netherlands;Department of General Practice, Academic Medical Center, Amsterdam; STI AIDS Netherlands, Amsterdam, The Netherlands;Epidemiology and Surveillance Unit, Centre for Infectious Diseases Control, RIVM, Bilthoven, The Netherlands;Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands;Department of Public Health, Erasmus MC—University Medical Center Rotterdam, Rotterdam, The Netherlands;NIVEL Primary Care Database, Sentinel Practices, Utrecht, The Netherlands;NIVEL Primary Care database, Utrecht, The Netherlands;

关键词: Partner notification;    Partner treatment;    Expedited partner therapy;    Patient-initiated partner treatment;    General practice;    Sexually transmitted infections;    Chlamydia trachomatis;   

DOI  :  10.1186/s12875-017-0676-3

 received in 2017-07-17, accepted in 2017-11-30,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundChlamydia prevalence remains high despite scaling-up control efforts. Transmission is not effectively interrupted without partner notification (PN) and (timely) partner treatment (PT). In the Netherlands, the follow-up of partners is not standardized and may depend on GPs’ time and priorities. We investigated current practice and attitude of GPs towards PN and PT to determine the potential for Patient-Initiated Partner Treatment, which is legally not supported yet.MethodsMultiple data-sources were combined for a landscape analysis. Quantitative data on (potential) PT were obtained from prescriptions in the national pharmacy register (2004–2014) and electronic patient data from NIVEL-Primary Care Database (PCD) and from STI consultations in a subgroup of sentinel practices therein. Furthermore, we collected information on current practice via two short questionnaires at a national GP conference and obtained insight into GPs’ attitudes towards PN/PT in a vignette study among GPs partaking in NIVEL-PCD.ResultsPrescription data showed Azithromycin double dosages in 1–2% of cases in the pharmacy register (37.000 per year); probable chlamydia-specific repeated prescriptions or double dosages of other antibiotics in NIVEL-PCD (115/1078) could not be interpreted as PT for chlamydia with certainty. STI consultation data revealed direct PT in 6/100 cases, via partner prescription or double doses. In the questionnaires the large majority of GPs (>95% of 1411) reported to discuss PN of current and ex-partner(s) with chlamydia patients. Direct PT was indicated as most common method by 4% of 271 GPs overall and by 12% for partners registered in the same practice. Usually, GPs leave further steps to the patients (83%), advising patients to tell partners to get tested (56%) or treated (28%). In the vignette study, 16–20% of 268 GPs indicated willingness to provide direct PT, depending on patient/partner profile, more (24–45%) if patients would have the chance to notify their partner first.ConclusionGPs in the Netherlands already treat some partners of chlamydia cases directly, especially partners registered in the same practice. Follow-up of partner notification and treatment in general practice needs more attention. GPs may be open to implement PIPT more often, provided there are clear guidelines to arrange this legally and practically.

【 授权许可】

CC BY   
© The Author(s). 2017