Nurse Delivered Field Therapy Offered for Public Health Department Patients with Gonorrhea and/or Chlamydia in South Carolina's Public Health Region 5

Background: 

: In South Carolina, the preferred method of treatment for patients with laboratory confirmed positive tests for gonorrhea and/or Chlamydia is a clinical appointment with a clinician. That said, parameters were developed for NDFT. Board certified and state licensed nurses were trained as DIS to offer Field Delivered Therapy (FDT) treatment to eligible Public Health Region 5 patients with untreated gonorrhea and/or Chlamydia who failed to return for treatment within 7 days of positive test analysis reported to the public health department.

Objectives: To describe improved and timely treatment outcomes in one public health region’s pilot project implementation of NDFT.

Methods: In September 2011 clinical and DIS staff in Public Health Region 5 reviewed Chlamydia and gonorrhea testing and treatment management from November-February, 08-09, 09-10 & 10-11. The baseline timeframe was 08-09. Data was collected from a review of STD medical records and NDFT referral forms - Partner Service Field Records.

Results: Baseline 08-09 timeframe 76.4% of Chlamydia and 89.0% of gonorrhea patients were treated in a clinical setting, NDFT was not available. During 09-10 timeframe NFDT provided treatment to 57 of 100 FDT eligible for 57%, 21% of “Number Accounted for Positive” (NACP) Chlamydia tests, and provided FDT to 14 of 16 FDT eligible for 87%, 25% of NACP Gonorrhea tests. During 10-11 timeframe NDFT provided treatment to 63 of 143 eligible for 44%, 25% of NACP Chlamydia tests, and treatment to 20 of the 22 eligible patients for 91%, 25% of NACP Gonorrhea tests.

Conclusions: Providing FDT improves "Number Accounted for Positive" treatment of untreated gonorrhea and/or Chlamydia in patients with laboratory diagnosed infection and offered FDT.

Implications for Programs, Policy, and Research:  FDT can be used with eligible patients to reduce disease progression; improve timeliness of treatment, and reduce complications in patients who fail to return to receive treatment.