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Better than nothing? Patient-delivered partner therapy and partner notification for chlamydia: the views of Australian general practitioners

机译：有总比没有好？衣原体患者提供的伴侣治疗和伴侣通知：澳大利亚全科医生的观点

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Background:\udGenital chlamydia is the most commonly notified sexually transmissible infection (STI) in Australia and worldwide and can have serious reproductive health outcomes. Partner notification, testing and treatment are important facets of chlamydia control. Traditional methods of partner notification are not reaching enough partners to effectively control transmission of chlamydia. Patient-delivered partner therapy (PDPT) has been shown to improve the treatment of sexual partners. In Australia, General Practitioners (GPs) are responsible for the bulk of chlamydia testing, diagnosis, treatment and follow up. This study aimed to determine the views and practices of Australian general practitioners (GPs) in relation to partner notification and PDPT for chlamydia and explored GPs' perceptions of their patients' barriers to notifying partners of a chlamydia diagnosis.\ud\udMethods:\udIn-depth, semi-structured telephone interviews were conducted with 40 general practitioners (GPs) from rural, regional and urban Australia from November 2006 to March 2007. Topics covered: GPs' current practice and views about partner notification, perceived barriers and useful supports, previous use of and views regarding PDPT.\ud\udTranscripts were imported into NVivo7 and subjected to thematic analysis. Data saturation was reached after 32 interviews had been completed.\ud\udResults:\udPerceived barriers to patients telling partners (patient referral) included: stigma; age and cultural background; casual or long-term relationship, ongoing relationship or not. Barriers to GPs undertaking partner notification (provider referral) included: lack of time and staff; lack of contact details; uncertainty about the legality of contacting partners and whether this constitutes breach of patient confidentiality; and feeling both personally uncomfortable and inadequately trained to contact someone who is not their patient. GPs were divided on the use of PDPT - many felt concerned that it is not best clinical practice but many also felt that it is better than nothing.\ud\udGPs identified the following factors which they considered would facilitate partner notification: clear clinical guidelines; a legal framework around partner notification; a formal chlamydia screening program; financial incentives; education and practical support for health professionals, and raising awareness of chlamydia in the community, in particular amongst young people.\ud\udConclusions:\udGPs reported some partners do not seek medical treatment even after they are notified of being a sexual contact of a patient with chlamydia. More routine use of PDPT may help address this issue however GPs in this study had negative attitudes to the use of PDPT. Appropriate guidelines and legislation may make the use of PDPT more acceptable to Australian GPs.
机译：背景：生殖器衣原体感染是澳大利亚和世界范围内最常通报的性传播感染（STI），可能具有严重的生殖健康后果。合作伙伴通知，测试和治疗是衣原体控制的重要方面。传统的伴侣通知方法无法达到足够的伴侣以有效控制衣原体的传播。病人提供伴侣治疗（PDPT）已被证明可以改善性伴侣的治疗。在澳大利亚，普通科医生（GPs）负责衣原体的大部分检测，诊断，治疗和随访。这项研究旨在确定澳大利亚全科医生（GPs）对衣原体感染的伴侣通知和PDPT的看法和做法，并探讨GP对患者告知衣原体诊断通知伴侣的障碍的看法。\ ud \ udMethods：\ udIn从2006年11月至2007年3月，对来自澳大利亚农村，区域和城市的40名全科医生进行了深度，半结构化的电话采访。主题涉及：GP的当前实践以及对合作伙伴通知，障碍和有用支持的看法， \ ud \ ud有关转录本的先前用法和观点。\ ud \ ud转录本已导入NVivo7，并进行了主题分析。在完成32次访谈后达到数据饱和。\ ud \ ud结果：\ ud对患者告知伴侣（患者转诊）的感知障碍包括：耻辱；年龄和文化背景；临时的或长期的关系，持续的关系与否。全科医生进行合作伙伴通知（提供者推荐）的障碍包括：时间和人员不足；缺乏联系方式；不确定与合作伙伴的合法性以及是否构成对患者保密的违反；并且感到自己不舒服并且没有得到足够的训练来与不是患者的人联系。 GP对PDPT的使用存在分歧-许多人担心这不是最佳的临床实践，但许多人也认为这总比没有好。有关合作伙伴通知的法律框架；正式的衣原体筛查计划；财政奖励;对卫生专业人员的教育和实践支持，并提高社区，特别是在年轻人中对衣原体的认识。\ ud \ ud结论：\ udGP报告说，即使有些伴侣在被告知与某人发生性接触后仍未寻求治疗。衣原体患者。常规使用PDPT可能有助于解决此问题，但是本研究中的GP对PDPT的使用持负面态度。适当的指南和法规可能使PDPT的使用更受澳大利亚GP的接受。

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