RT Journal Article
SR Electronic
T1 Utilization of Treatment for Chlamydia and Gonorrhea in the Primary Care Setting Using the American Family Cohort
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 6604
DO 10.1370/afm.22.s1.6604
VO 22
IS Supplement 1
A1 Kamdar, Neil
A1 Phillips, Robert
A1 Tao, Guoyu
A1 Hao, Shiying
YR 2024
UL http://www.annfammed.org/content/22/Supplement_1/6604.abstract
AB Context: Chlamydia and gonorrhea are the two most common sexually transmitted infections (STI) in the United States. Since untreated cases can have severe health consequences, non-adherence to the Centers for Disease Control and Prevention Sexually Transmitted Disease Treatment guidelines (CDC) remains a concern.Objective: This study examined guideline adherence for chlamydia and gonorrhea treatment in primary care settings.Study Design and Analysis: A retrospective cohort from 2018-2022. Unadjusted and adjusted time ratios were estimated using shared frailty parametric multivariable Weibull Accelerated Failure Time Models (AFT).Setting or Dataset: Electronic health records from the PRIME Registry, years 2018-2022. The electronic health records are stored in the American Family Cohort, the largest national United States primary care database.Population Studied: Study population were patients having one or more chlamydia and/or gonorrhea infections between 2018 and 2022 identified with a confirmed, positive test result from the electronic medical records.Intervention/Instrument: Key patient characteristics such as race/ethnicity and social determinants of health were considered.Outcome Measures: The primary outcome was the first date of CDC-recommended medication administered within 30-days. The secondary outcome was the time to first date of any antibiotic medication within 30-days.Results: We identified 6,678 confirmed positive tested chlamydia cases and 2,206 confirmed positive tested gonorrhea cases, with 75.3% and 69.6% treatment rates, respectively. Females, individuals aged 10-29, those living in suburban areas, and patients with STI co-infections saw higher treatment rates compared to other groups. 15% of the chlamydia cases were treated using doxycycline, and 38.7% of gonorrhea cases were treated by ceftriaxone. Chlamydia cases among older adults and Non-Hispanic Blacks had longer time to treatment.Conclusion: Barriers to guideline adherence remain for chlamydia and gonorrhea treatment across primary care practices. Efforts are needed to develop management plans for better quality of STI-related care and health equity.