Public health detailing to increase expedited partner therapy for chlamydia and gonorrhea in Maryland: Changes in awareness and implementation among prescribing community providers

The objective of this evaluation was to assess the use of public health detailing in a pilot program to increase Expedited Partner Therapy (EPT) uptake among community-based providers in two Maryland jurisdictions. Public health detailing is a method designed to raise awareness and increase implementation of evidence-based clinical practices by delivering educational content via one-on-one meetings with providers. EPT is a voluntary clinical practice of treating all sexual partners of patients diagnosed with STIs by prescribing medications without the provider first examining said sexual partners. The aim of EPT is to prevent STI reinfection and reduce further transmission. From April 2017 to March 2019, detailers visited community-based health care practice sites to conduct EPT detailing with providers. The effectiveness of this program was evaluated by comparing provider responses from pre- to post-detailing surveys, administered six months after detailing. Survey responses assessed EPT awareness and practices, barriers to implementation, and satisfaction with detailing. The proportion of providers (170) aware of EPT for treating chlamydia and gonorrhea increased from 61.7% (114) to 99.4% (169) (p-value < 0.001). The proportion who reported prescribing EPT increased from 63.2% (72) to 86.4% (146) (p-value < 0.001). Providers reporting no barriers to prescribing EPT increased from 30.6% (52) to 55.9% (95) (p-value < 0.001). Most providers were satisfied with detailing, 95.5% (164), and 95.3% (162) preferred this method to communicate about public health measures. Detailing appears to be a strategy to improve provider awareness of EPT, increase EPT implementation, and reduce barriers to prescribing EPT.