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Background: EPT is recommended by CDC as an option to facilitate treatment for partners of patients that test positive for CT and GC. EPT for CT has been legal in TN since 2002. Little information is known regarding the extent to which EPT is utilized among physicians practicing in the state.
Objectives: Assess and describe EPT implementation practices and barriers within a health department setting.
Methods: In March 2011, with CDC and TN DOH partners, CAI facilitated on-site assessments of practices related to EPT utilization at an STD clinic in TN. Key informant surveys were conducted among 6 staff, Room Study to assess implementation practices was conducted over 6 days, protocols and materials were reviewed, and an analysis of “hand-tallied” data used to monitor distribution of EPT medication from May 2006 through August of 2010 was analyzed.
Results: TN EPT policies require a laboratory confirmed CT test be available to provide EPT. RNs offer and distribute EPT to eligible clients. Room study data reveal 88% of eligible clients (with a laboratory confirmed CT test) were offered EPT, of those offered 71% accepted. “Hand-tallied” data was not used to evaluate implementation of EPT. “Hand-tallied” data analysis revealed an increasing trend in utilization of EPT from 18% in 2006 to 46% over 4 consecutive months in 2010.
Conclusions: Eligible clients are offered and accept EPT at high rates. EPT utilization increased over time. Conducting a time-limited Room Study is a promising way to assess EPT implementation. Enhancement of “Hand-Tallied” data to include those presumptively treated would increase understanding of true rates of EPT utilization over time.
Implications for Programs, Policy, and Research: Low cost or no cost systems to assess EPT implementation rates can provide important information to STD program managers to facilitate continuous quality improvement. Understanding how presumptive treatment rates influence observed EPT rates is important.