Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
BMC Primary Care
Published in: BMC Primary Care 1/2017

Open Access 01-12-2017 | Research article

Partner notification and partner treatment for chlamydia: attitude and practice of general practitioners in the Netherlands; a landscape analysis

Authors: Ingrid V. F. van den Broek, Gé A. Donker, Karin Hek, Jan E. A. M. van Bergen, Birgit H. B. van Benthem, Hannelore M. Götz

Published in: BMC Primary Care | Issue 1/2017

Login to get access

Abstract

Background

Chlamydia prevalence remains high despite scaling-up control efforts. Transmission is not effectively interrupted without partner notification (PN) and (timely) partner treatment (PT). In the Netherlands, the follow-up of partners is not standardized and may depend on GPs’ time and priorities. We investigated current practice and attitude of GPs towards PN and PT to determine the potential for Patient-Initiated Partner Treatment, which is legally not supported yet.

Methods

Multiple data-sources were combined for a landscape analysis. Quantitative data on (potential) PT were obtained from prescriptions in the national pharmacy register (2004–2014) and electronic patient data from NIVEL-Primary Care Database (PCD) and from STI consultations in a subgroup of sentinel practices therein. Furthermore, we collected information on current practice via two short questionnaires at a national GP conference and obtained insight into GPs’ attitudes towards PN/PT in a vignette study among GPs partaking in NIVEL-PCD.

Results

Prescription data showed Azithromycin double dosages in 1–2% of cases in the pharmacy register (37.000 per year); probable chlamydia-specific repeated prescriptions or double dosages of other antibiotics in NIVEL-PCD (115/1078) could not be interpreted as PT for chlamydia with certainty. STI consultation data revealed direct PT in 6/100 cases, via partner prescription or double doses. In the questionnaires the large majority of GPs (>95% of 1411) reported to discuss PN of current and ex-partner(s) with chlamydia patients. Direct PT was indicated as most common method by 4% of 271 GPs overall and by 12% for partners registered in the same practice. Usually, GPs leave further steps to the patients (83%), advising patients to tell partners to get tested (56%) or treated (28%). In the vignette study, 16–20% of 268 GPs indicated willingness to provide direct PT, depending on patient/partner profile, more (24–45%) if patients would have the chance to notify their partner first.

Conclusion

GPs in the Netherlands already treat some partners of chlamydia cases directly, especially partners registered in the same practice. Follow-up of partner notification and treatment in general practice needs more attention. GPs may be open to implement PIPT more often, provided there are clear guidelines to arrange this legally and practically.
Footnotes
1
 
Literature
1.
van den Broek I, van Aar F, van Oeffelen A, et al.: Sexually transmitted infections in the Netherlands in 2015. In: RIVM report. vol. 2016–0027. Bilthoven, The Netherlands: RIVM; 2016.
2.
Götz H, Wolfers M, Luijendijk A, van den Broek I. Retesting for genital Chlamydia trachomatis among visitors of a sexually transmitted infections clinic: randomized intervention trial of home- versus clinic-based recall. BMC Infect Dis. 2013;13:239.CrossRefPubMedPubMedCentral
3.
Hosenfeld C, Workowski K, Bouman S, Zaidi A, Dyson J, Mosure D, Bolan G, Bauer H. Repeat infection with Chlamydia and gonorrhea among females: a systematic review of the literature. Sex Transm Dis. 2009;36(8):478–89.CrossRefPubMed
4.
Kampman C, Koedijk F, Driessen-Hulshof H, Hautvast J, van den Broek I. Retesting young STI clinic visitors with urogenital Chlamydia trachomatis infection in the Netherlands; response to a text message reminder and reinfection rates: a prospective study with historical controls. Sex Transm Infect. 2016;92(2):124–9.CrossRefPubMed
5.
Geisler W, Lensing S, Press C, Hook E. Spontaneous resolution of genital Chlamydia trachomatis infection in women and protection from reinfection. J Infect Dis. 2013;207(12):1850–6.CrossRefPubMedPubMedCentral
6.
Ferreira A, Young T, Mathews C, Zunza M, Low N. Strategies for partner notification for sexually transmitted infections, including HIV. Cochrane Database Syst Rev. 2013;3(10):CD002843.
7.
Van Bergen J, Dekker J, Boeke A, Kronenberg E, Van der Spruit R, Burgers J, Bouma M, Verlee E. Dutch GP guideline on STI consultations [guidelines in Dutch: NHG-Standaard het soa-consult (Eerste herziening)]. Huisarts en Wetenschap. 2013;56:450–63.CrossRef
8.
de Vries H, van Doornum G, Bax C, al. e: Multidisciplinary guidelines sexually transmitted diseases secondary care [guidelines in Dutch: Multidisciplinaire Richtlijn Seksueel Overdraagbare Aandoeningen voor de 2e Lijn]. In. Nederlandse Vereniging voor Dermatologie en Venereologie; 2012. www.​huidarts.​info.
9.
Gotz HM, van Rooijen MS, Vriens P, Op de Coul E, Hamers M, Heijman T, van den Heuvel F, Koekenbier R, van Leeuwen AP, Voeten HA. Initial evaluation of use of an online partner notification tool for STI, called 'suggest a test’: a cross sectional pilot study. Sex Transm Infect. 2014;90(3):195–200.CrossRefPubMed
10.
11.
Centers for Disease Control and Prevention: Expedited partner therapy in the management of sexually transmitted diseases.. In. Edited by US DEpartment of Health and Human Services. Atlanta, GA,; 2006.
12.
Oliver A, Rogers M, Schillinger J: The Impact of Prescriptions on Sex Partner Treatment Using Expedited Partner Therapy for Chlamydia trachomatis Infection, New York City, 2014–2015. Sex Transm Dis. 2016;43(11):673-78.
13.
Schillinger J, Kissinger P, Calvet H, Whittington W, Ransom R, Sternberg M, Berman S, Kent C, Martin D, Oh M, et al. Patient-delivered partner treatment with azithromycin to prevent repeated Chlamydia trachomatis infection among women: a randomized, controlled trial. Sex Transm Dis. 2003;30(1):49–56.CrossRefPubMed
14.
Golden M, Whittington W, Handsfield H, Hughes J, Stamm W, Hogben M, Clark A, Malinski C, Helmers J, Thomas K, et al. Effect of expedited treatment of sex partners on recurrent or persistent gonorrhea or chlamydial infection. N Engl J Med. 2005;352(7):676–85.CrossRefPubMed
15.
Kissinger P, Mohammed H, Richardson-Alston G, Leichliter J, Taylo S, Martin D, Farley T: Patient-delivered partner treatment for male urethritis: a randomized, controlled trial. Clin Infect Dis 2005, 41(5):623-629.
16.
Golden M, Kerani R, Stenger M, Hughes J, Aubin M, Malinski C, Holmes K. Uptake and population-level impact of expedited partner therapy (EPT) on Chlamydia trachomatis and Neisseria gonorrhoeae: the Washington state community-level randomized trial of EPT. PLoS Med. 2015;12(1):e1001777.CrossRefPubMedPubMedCentral
17.
18.
Estcourt C, Sutcliffe L, Copas A, Mercer C, Roberts T, Jackson L, Symonds M, Tickle L, Muniina P, Rait G, et al. Developing and testing accelerated partner therapy for partner notification for people with genital Chlamydia trachomatis diagnosed in primary care: a pilot randomised controlled trial. Sex Transm Infect. 2015;91(8):548–54.CrossRefPubMedPubMedCentral
19.
Cameron S, Glasier A, Muir A, Scott G, Johnstone A, Quarrell H, Oroz C, McIntyre M, Miranda D, Todd G. Expedited partner therapy for Chlamydia trachomatis at the community pharmacy. BJOG. 2010;117(9):1074–9.CrossRefPubMed
20.
Dombrowski J, Golden M. Accelerated partner therapy: a promising new partner treatment option. Sex Transm Infect. 2012;88(1):2–3.CrossRefPubMed
21.
Van den Broek IV, Donker GA, Hek K, Van Benthem BHB, van Bergen JEAM, Götz HM P3.224 Partner notification and partner treatment for chlamydia: atttitude and practice of general practitioners in the Netherlands. Sexually Transmitted Infections. 2017;93(Suppl 2):A177. doi:10.​1136/​sextrans-2017-053264.​459.
22.
van den Broek I, Verheij R, van Dijk C, Koedijk F, van der Sande M, van Bergen J. Trends in sexually transmitted infections in the Netherlands, combining surveillance data from general practices and sexually transmitted infection centres. BMC Fam Pract. 2010;11:39.CrossRefPubMedPubMedCentral
23.
Peabod J, Luck J. P G, Jain S, Hansen J, spell M: measuring the quality of physician practice by using clinical vignettes: a prospective validation study. Ann Intern Med. 2004;141(10):771–80.CrossRef
24.
Peabody J, Luck J, Glassman P, Dresselhaus T, Lee M. Comparison of vignettes, standardized patients, and chart abstraction: a prospective validation study of 3 methods for measuring quality. JAMA. 2000;283(13):1715–22.CrossRefPubMed
25.
26.
Hogben M, McCree DH, Golden MR. Patient-delivered partner therapy for sexually transmitted diseases as practiced by U.S. physicians. Sex Transm Dis. 2005;32(2):101–5.CrossRefPubMed
27.
Okah E, Arya V, Rogers M, Kim M, Schillinger JA. Sentinel surveillance for expedited partner therapy prescriptions using pharmacy data, in 2 new York City neighborhoods, 2015. Sex Transm Dis. 2017;44(2):104–8.CrossRefPubMed
28.
Cameron S, Glasier A, Scott G, Young H, Melvin L, Johnstone A, Elton R. Novel interventions to reduce re-infection in women with chlamydia: a randomized controlled trial. Hum Reprod. 2009;24(4):888–95.CrossRefPubMed
29.
Hogben M, Collins D, Hoots B, OʼConnor K: Partner Services in Sexually Transmitted Disease Prevention Programs: a review. Sex Transm Dis 2016, 43(2 Suppl 1):S53-S62.
30.
31.
32.
Althaus C, Turner K, Mercer C, Auguste P, Roberts T, Bell G, Herzog S, Cassell J, Edmunds W, White P, et al. Effectiveness and cost-effectiveness of traditional and new partner notification technologies for curable sexually transmitted infections: observational study, systematic reviews and mathematical modelling. Health Technol Assess. 2014;18(3):1–100.PubMedPubMedCentral
33.
Althaus CL, Heijne JC, Herzog SA, Roellin A, Low N. Individual and population level effects of partner notification for Chlamydia trachomatis. PLoS One. 2012;7(12):e51438.CrossRefPubMedPubMedCentral
34.
Rosenfeld E, Marx J, Terry M, Stall R, Flatt J, Borrero S, Miller E. Perspectives on expedited partner therapy for chlamydia: a survey of health care providers. Int J STD AIDS. 2016;27(13):1180–6.CrossRefPubMed
35.
Goldsworthy R, Fortenberry D. Patterns and determinants of patient-delivered therapy uptake among healthcare consumers. Sex Transm Dis. 2009;36(1):25–32.CrossRefPubMed
36.
Forbes G, Clutterbuck D. How many cases of chlamydial infection would we miss by not testing partners for infection? Int J STD AIDS. 2009;20(4):267–8.CrossRefPubMed
37.
38.
39.
Wind CM, van der Loeff MF S, van Dam AP, de Vries HJ, van der Helm JJ. Trends in antimicrobial susceptibility for azithromycin and ceftriaxone in Neisseria gonorrhoeae isolates in Amsterdam, the Netherlands, between 2012 and 2015. Euro surveillance. 2017;22:1.
Metadata
Title
Partner notification and partner treatment for chlamydia: attitude and practice of general practitioners in the Netherlands; a landscape analysis
Authors
Ingrid V. F. van den Broek
Gé A. Donker
Karin Hek
Jan E. A. M. van Bergen
Birgit H. B. van Benthem
Hannelore M. Götz
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2017
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-017-0676-3

Other articles of this Issue 1/2017

BMC Primary Care 1/2017 Go to the issue

Research article

Immigrant parents’ experience with the Swedish child health care system: A qualitative study

Research article

Experiences of adult patients using primary care services in Poland – a cross-sectional study in QUALICOPC study framework

Research article

Self-treatment of acute exacerbations of chronic obstructive pulmonary disease requires more than symptom recognition – a qualitative study of COPD patients’ perspectives on self-treatment

Research article

Family-centered depression treatment for older men in primary care: a qualitative study of stakeholder perspectives

Research article

“I can’t bend it and it hurts like mad”: direct observation of gout consultations in routine primary health care

Research article

Impact of a continuing medical education meeting on the use and timing of urgent cancer referrals among general practitioners - a before-after study