Research Mentor(s): Rachel Solnick, IHPI Fellow & Emergency Medicine Attending
Research Mentor School/College/Department: Institute for Healthcare Policy and Innovation, Michigan Medicine
Presentation Date: Thursday, April 22, 2021
Session: Session 5 (3pm-3:50pm)
Breakout Room: Room 14
Background: Rates of sexually transmitted infections (STIs) in the United States are rising dramatically. EDs serve as the primary source of care for many patients diagnosed with STIs. Expedited Partner Therapy (EPT), an evidence-based practice for treating partners of patients with STIs without an exam, can decrease rates of STI reinfection and increase the number of partners treated. Despite the potential benefits of EPT, its use in EDs is poorly understood. Objective: This study characterizes the knowledge, beliefs, interest, and practice of EPT among academic ED medical directors through a cross-sectional survey. We also explore barriers and facilitators to EPT implementation through semi-structured interviews of medical directors and key informants conducted using an interview guide informed by the Consolidated Framework for Implementation Science. Interviews were recorded, transcribed, and iteratively coded, and qualitative thematic analysis was used to identify themes and subthemes by consensus. Results: A total of 48 out of 70 medical directors responded. There was a high awareness of EPT (73%), but only 38% knew how to prescribe EPT, and even fewer (19%) had actually implemented it. Most respondents supported EPT (79%), and were more likely to support EPT if they were already aware of it (89% vs 54%). 41% of those who had not implemented EPT thought that it would be feasible, and 56% thought that departmental support would be likely. Many participants cited medicolegal barriers and lack of clarity regarding the ED’s role in STI care as obstacles to EPT adoption. Other participants cited a perceived benefit of EPT use was the prevention of untreated STIs, particularly among a vulnerable population. Conclusion: Our findings show relatively low use but high interest in EPT in academic EDs, and show the need for increased awareness to implement this public health intervention in the ED setting.