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Original article
Developing and testing accelerated partner therapy for partner notification for people with genital Chlamydia trachomatis diagnosed in primary care: a pilot randomised controlled trial
  1. Claudia S Estcourt1,
  2. Lorna J Sutcliffe1,
  3. Andrew Copas2,
  4. Catherine H Mercer2,
  5. Tracy E Roberts3,
  6. Louise J Jackson3,
  7. Merle Symonds1,
  8. Laura Tickle4,
  9. Pamela Muniina2,
  10. Greta Rait2,
  11. Anne M Johnson2,
  12. Kazeem Aderogba5,
  13. Sarah Creighton6,
  14. Jackie A Cassell7
  1. 1Blizard Institute, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK
  2. 2Research Department of Infection & Population Health, University College London, London, UK
  3. 3Health Economics Unit, School of Population and Health Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
  4. 4Barts Sexual Health Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
  5. 5Department of Sexual Health, Eastbourne District General Hospital, East Sussex Healthcare NHS Trust, Eastbourne, UK
  6. 6Homerton Sexual Health Services, Homerton Hospital, London, UK
  7. 7Division of Primary Care & Public Health, Brighton & Sussex Medical School, University of Brighton, Brighton, UK
  1. Correspondence to Dr Claudia S Estcourt, Blizard Institute, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, EC1A 5BE, UK; c.s.estcourt{at}qmul.ac.uk

Abstract

Background Accelerated partner therapy (APT) is a promising partner notification (PN) intervention in specialist sexual health clinic attenders. To address its applicability in primary care, we undertook a pilot randomised controlled trial (RCT) of two APT models in community settings.

Methods Three-arm pilot RCT of two adjunct APT interventions: APTHotline (telephone assessment of partner(s) plus standard PN) and APTPharmacy (community pharmacist assessment of partner(s) plus routine PN), versus standard PN alone (patient referral). Index patients were women diagnosed with genital chlamydia in 12 general practices and three community contraception and sexual health (CASH) services in London and south coast of England, randomised between 1 September 2011 and 31 July 2013.

Results 199 women described 339 male partners, of whom 313 were reported by the index as contactable. The proportions of contactable partners considered treated within 6 weeks of index diagnosis were APTHotline 39/111 (35%), APTPharmacy 46/100 (46%), standard patient referral 46/102 (45%). Among treated partners, 8/39 (21%) in APTHotline arm were treated via hotline and 14/46 (30%) in APTPharmacy arm were treated via pharmacy.

Conclusions The two novel primary care APT models were acceptable, feasible, compliant with regulations and capable of achieving acceptable outcomes within a pilot RCT but intervention uptake was low. Although addition of these interventions to standard PN did not result in a difference between arms, overall PN uptake was higher than previously reported in similar settings, probably as a result of introducing a formal evaluation. Recruitment to an individually randomised trial proved challenging and full evaluation will likely require service-level randomisation.

Trial registration number Registered UK Clinical Research Network Study Portfolio id number 10123.

  • CHLAMYDIA TRACHOMATIS
  • PRIMARY CARE
  • PARTNER NOTIFICATION
  • CLINICAL STI CARE
  • COMPEX INTERVENTIONS

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

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