ADOPTing a new method of partner management for genital chlamydia in New South Wales: findings from a pilot implementation program of patient-delivered partner therapy
Rebecca Lorch
A K , Christopher Bourne A B , Leanne Burton B , Larissa Lewis A , Katherine Brown C , Deborah Bateson D , Vickie Knight E , Catriona Ooi F , Naomi Hoffman G , Judith Mackson H , Hilary Bower D , Mary Stewart D , Nicola Moll I , Joanne Micallef A , Julie Mooney-Somers J , Basil Donovan A E , John Kaldor A and Rebecca Guy A
A Kirby Institute, Wallace Wurth Building, UNSW Sydney, NSW 2052, Australia.
B NSW STI Programs Unit, Centre for Population Health, NSW Health, 150 Albion Street, Surry Hills, NSW 2010, Australia.
C Illawarra Sexual Health Service, Port Kembla Hospital, Warrawong, NSW 2502, Australia.
D Family Planning New South Wales, 328–336 Liverpool Road, Ashfield, NSW 2131, Australia.
E Sydney Sexual Health Centre, Nightingale Wing, Sydney Eye Hospital, Sydney, NSW 2000, Australia.
F Clinic 16, Northern Sydney Local Health District Sexual Health Service, 2C Herbert Street, St Leonards, NSW 2065, Australia.
G Liverpool Sexual Health Service, 13 Elizabeth Street, Liverpool, NSW 2170, Australia.
H Chief Pharmacist Unit, Legal and Regulatory Services Branch, NSW Ministry of Health, 73 Miller Street, North Sydney, NSW 2060, Australia.
I NSW Royal Australian College of General Practitioners, 12 Mount Street, North Sydney, NSW 2060, Australia.
J Sydney Health Ethics, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia.
K Corresponding author. Email: rlorch@kirby.unsw.edu.au
Sexual Health 16(4) 332-339 https://doi.org/10.1071/SH18169
Submitted: 7 September 2018 Accepted: 8 March 2019 Published: 24 May 2019
Abstract
Background: Patient-delivered partner therapy (PDPT) for chlamydia is an effective and safe additional partner management strategy. Some Australian regulatory changes have been made to support PDPT, but implementation guidance is lacking. This paper describes a pilot implementation program of PDPT in New South Wales (NSW), the Australian Development and Operationalisation of Partner Therapy (ADOPT). Methods: ADOPT involved: (1) clarification of the NSW PDPT legal and policy framework; (2) development and implementation of PDPT service models, resources and data collection tools for select publicly funded sexual health services (PFSHS) and Family Planning (FP) NSW clinics; and (3) evaluation of PDPT uptake. Results: PDPT can be undertaken in NSW if accompanied by adequate provider, patient and partner information. Regulatory amendments enabled medication prescribing. The pilot implementation took place in four PFSHS and five FPNSW clinics from January to December 2016. In PFSHS, 30% of eligible patients were offered PDPT and 89% accepted the offer. In FPNSW clinics, 42% of eligible patients were offered PDPT and 63% accepted the offer. Most partners for whom PDPT was accepted were regular partners. Conclusions: A close collaboration of researchers, policy makers and clinicians allowed successful implementation of a PDPT model for chlamydia in heterosexual patients at select PFSHS and FPNSW clinics, providing guidance on its use as standard of care. However, for the full public health benefits of PDPT to be realised, it must be implemented in general practice, where most chlamydia is diagnosed. Further work is recommended to explore feasibility, develop guidelines and promote the integration of PDPT into general practice.
Additional keywords: chlamydia treatment, heterosexual, partner notification.
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