Evaluation of 2010 Treatment Rates Relative to Treatment Practices in Philadelphia Family Planning Clinics

Background: Gonorrhea (GC) rates increased nearly 35% in 2010 compared to 2009 and chlamydia (CT) remains the most commonly reported disease in Philadelphia. Treatment soon after diagnosis of these infections can reduce transmission and complications. The Philadelphia Department of Public Health (PDPH) collaborates with the Family Planning Council (FPC) to assure that patients who test positive for CT/GC at Philadelphia FPC clinics receive timely, proper treatment.

Objectives: To understand CT/GC treatment practices relative to treatment rates reported to PDPH.

Methods:  A phone-based survey that assessed the time and method for laboratory result receipt, patient notification of test results, administration of treatment, report of treatment to PDPH, facility characteristics, and any planned changes to these processes was conducted with Philadelphia FPC clinics. Responses were compared with average time to treatment at each clinic.

Results: Thirty-three of 39 FPC sites completed the survey. Nine clinics treated over 80% of patients within 14 days of testing and 12 clinics treated fewer than 50%. Providing patient results over the phone (p=0.03) and attempting to notify patients on the day results are received (p=0.03) were significantly associated with shorter time to treatment.  Nearly every clinic reported difficulty in notifying patients due to incorrect contact information.

Conclusions: This survey identified specific clinics that have difficulty treating patients within 14 days. Improving time to treatment at these clinics will increase the FPC 14 day treatment rate to over 80%.  The survey also demonstrated practices associated with rapid treatment and reporting and issues with loss of patients for follow-up. PDPH and the FPC will provide FPC sites with survey results, standardized forms, and suggestions for practices to improve treatment time.

Implications for Programs, Policy, and Research: Provider surveys are an easy way to identify areas for improvement that should help reduce STD transmission within localities.