title: Implementation and effectiveness of an expedited partner therapy program in an urban clinic.
abstract: BACKGROUND
  Partner notification of exposure to gonorrhea or chlamydia is traditionally conducted by the index case or a disease intervention specialist. However, a significant proportion of partners remain untreated and thus are at risk for continued transmission. Expedited partner therapy (EPT) obviates the requirement for a health care visit by the partner: the index case delivers medications to the partner. Although shown to be efficacious in randomized control trials, effectiveness studies of delivering EPT in real-world situations are needed. We describe the implementation, patient characteristics, and clinical impact of an EPT program at the Denver Metro Health Clinic (DMHC).
  
  
  METHODS
  We identified 2578 patient visits eligible for EPT (heterosexual men or women diagnosed as having chlamydia or gonorrhea) from November, 2006, to April, 2011. We examined EPT acceptance rates over clinical process improvements. To measure clinical impact, we assessed the association between initial acceptance of EPT and infection status among 351 patients who returned for retesting.
  
  
  RESULTS
  Requiring complete documentation of EPT in the clinic electronic medical record increased EPT acceptance from 20% to 48%. Expedited partner therapy acceptance was associated with a reduced risk of chlamydial reinfection (odds ratio, 0.7; 95% confidence interval, 0.3-1.6) and a reduced risk of gonorrheal reinfection (odds ratio, 0.5; 95% confidence interval, 0.2-1.4); however, these changes were not statistically significant.
  
  
  CONCLUSIONS
  Expedited partner therapy at the DMHC was substantially enhanced by process changes in the clinic and may be associated with a decreased risk of reinfection.
authors.affiliation: Department of Public Health, Denver Health and Hospital Authority, Colorado School of Public Health, University of Colorado, Denver, CO 80204, USA. theresa.mickiewicz@dhha.org
authors.forename: Theresa
authors.initials: T
authors.lastname: Mickiewicz
authors.forename: Alia
authors.initials: A
authors.lastname: Al-Tayyib
authors.forename: Mark
authors.initials: M
authors.lastname: Thrun
authors.forename: Cornelis
authors.initials: C
authors.lastname: Rietmeijer
mesh_terms: D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission*; D003120:Colorado / Q000453:epidemiology; D016358:Contact Tracing; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission*; D017408:Guidelines as Topic; D020010:Heterosexuality; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012747:Sexual Partners; D014505:Urban Population; D055815:Young Adult