Developing and testing Accelerated Partner Therapy for partner notification for people with genital chlamydia trachomatis diagnosed in primary care: a pilot randomised controlled trial

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), vs standard PN alone (patient referral). Index patients were women diagnosed with genital chlamydia in 12 general practices and three community contraception and sexual health services in London and south coast of England, randomised 1 Sept 2011-31 July 2013.

Results: 199 women described 339 male partners, of whom 313 were reported by the index as contactable. Proportions of contactable partners considered treated within six 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.