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Background: Expedited partner therapy (EPT) for Chlamydia trachomatis(Ct) is the practice of providing a (Ct)-infected patient with medication or prescription to treat his or her sex partner(s) without first examining those partners. When EPT is provided in the form of a prescription (“prescription EPT”, (p-EPT)), it is assumed the patient or partner will take the prescription to a pharmacy to be filled. New York City (NYC) providers commonly employ p-EPT, yet NYC pharmacists report only occasional receipt of EPT prescriptions. The purpose of this study was to directly assess the frequency of EPT prescriptions filled by NYC pharmacies.
Methods: Facilities reporting high p-EPT use were identified from Ct provider case reports; pharmacies in close proximity to these facilities were visited during January-February, 2016. Prescriptions filled in 2015 for Azithromycin, 1 or 2 grams, were reviewed, and data on the patient’s gender and age, the prescribing provider and facility, and prescribing instructions were extracted.
Results: Among the 26 pharmacies approached, 12 (46%) participated and had filled 387 prescriptions for 1g azithromycin and 118 prescriptions for two 1g doses of azithromycin (double-dose). Among these, there were 102 EPT prescriptions; 77% (79/102) were double-dose and specified treatment for both patient and partner. One pharmacy filled 79% (81/102) of EPT prescriptions. Assuming all non-EPT, single-dose azithromycin prescriptions were index-patient treatments, and including the index-patient dose on double-dose prescriptions, there were 0.2 partners treated per index-patient; after excluding the outlier pharmacy, there were 0.07 partners treated per index-patient.
Conclusions: EPT prescriptions are received in NYC pharmacies near to EPT-prescribing facilities. Excluding the outlier pharmacy, EPT prescriptions appeared uncommon at NYC pharmacies, suggesting that patients and partners may not take them to pharmacies, and pointing to the potential benefit of public health funded programs that distribute EPT partner packets to diagnosing providers.