Rates of Expedited Partner Therapy Prescribed by OB/GYN Residents at LA County Hospitals [15A

Abstract

INTRODUCTION: The incidence of STIs, specifically gonorrhea, chlamydia, and trichomoniasis among Los Angeles County residents is on the rise. One possible explanation is inadequate treatment, especially of sexual partners. Expedited partner therapy (EPT) is a method of treating patients' partners without a separate healthcare visit, which has been shown to decrease persistent and/or recurrent infections. We report on quality improvement outcomes following interventions to help increase the rates of EPT provision. METHODS: Interventions included creating a protocol with the pharmacy, arranging for Cefixime to be on formulary, and conducting resident training sessions. Data collection was performed on all positive gonorrhea (GC), chlamydia (CT) and trichomoniasis lab results seen from January 1, 2017 to February 27, 2019 across all departments, inclusive of Ob/Gyn. EPT rates before and after interventions are presented. RESULTS: The rates of EPT prescriptions provided by OB/GYN providers for STI treatment increased following the interventions. EPT for GC/CT increased from 40% to 55% of cases; EPT for Trichomonas increased from 38% to 85%. Interestingly, patients were often counseled on the need for partner treatment, but were not given prescriptions. This study includes only female patients seen by Ob/Gyn providers, though the majority of results were detected in the emergency department by non Ob/Gyn providers. CONCLUSION: Following interventions aimed at establishing agreements with the pharmacy as well as increasing awareness among residents, the EPT rates of gonorrhea, chlamydia, and trichomoniasis did increase significantly. This may assist with decreasing the rate of STI reinfection among County hospitals and hospitals supported by medical trainees.