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首页> 外文期刊>BMC Family Practice >Partner notification and partner treatment for chlamydia: attitude and practice of general practitioners in the Netherlands; a landscape analysis
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Partner notification and partner treatment for chlamydia: attitude and practice of general practitioners in the Netherlands; a landscape analysis

机译：衣原体的伴侣通知和伴侣治疗：荷兰全科医生的态度和做法;景观分析

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Chlamydia 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. Multiple 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. Prescription 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. GPs 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.
机译：尽管加大了控制力度，衣原体感染率仍然很高。没有伙伴通知（PN）和（及时）伙伴治疗（PT），传输不会有效中断。在荷兰，合作伙伴的后续行动不规范，可能取决于GP的时间和优先级。我们调查了全科医生对PN和PT的当前做法和态度，以确定患者发起伴侣治疗的可能性，但法律上尚不支持。合并了多个数据源以进行景观分析。 （潜在的）PT的定量数据是从国家药局（2004-2014）的处方中获得的，以及从NIVEL-初级保健数据库（PCD）和其中的前哨实践分组的STI咨询中获得的电子患者数据。此外，我们在全国GP会议上通过两个简短的问卷调查收集了有关当前实践的信息，并通过NIVEL-PCD中GP参与的小插图研究深入了解了GP对PN / PT的态度。处方数据显示，在药房登记簿中，阿奇霉素双倍剂量的使用率为1-2％（每年37.000）; NIVEL-PCD（115/1078）中可能存在的衣原体特异性重复处方或其他抗生素的双重剂量不能肯定地解释为衣原体的PT。 STI咨询数据显示，通过伴侣处方或两次剂量，直接PT发生在6/100例中。在问卷中，绝大多数全科医生（> 1411的95％）报告与披衣菌患者讨论现任和前任合伙人的PN。在271名普通合伙人中，有4％的人表示直接PT，而在同一实践中注册的合伙人则以12％的人表示直接PT。通常，家庭医生会给患者留下更多的步骤（83％），建议患者告诉伴侣进行测试（56％）或接受治疗（28％）。在小插图研究中，268位全科医生的16–20％表示愿意提供直接PT，具体取决于患者/合作伙伴的概况，如果患者有机会首先通知其伴侣，则更多（24–45％）。荷兰的全科医生已经直接治疗了衣原体案件的某些合伙人，特别是在相同做法中注册的合伙人。一般情况下，对伴侣通知和治疗的跟进需要更多关注。如果有明确的准则在法律上和实际上进行安排，GP可能会更开放地实施PIPT。

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