Patient Delivered Partner Therapy

What is Patient Delivered Partner Therapy (PDPT)?

• PDPT is where the diagnosing clinician provides either an additional prescription or course of antibiotic treatment to the index case for the treatment of their partner/s, without first seeing the partner/s.
• PDPT has been shown to reduce reinfection in the index case compared with simple patient referral^1,2,3 and can reduce time to partner treatment.⁴
• In Australia, a single one gram dose orally of azithromycin is used for PDPT. 

Who is it suitable for?

Clinicians should discuss partner management options with their patient (including PDPT) to support patients in deciding on the best option. 

PDPT is most suitable for heterosexual patients with anogenital or oropharyngeal chlamydia whose partners are unable or unlikely to seek timely care themselves, or when the index patient has a repeat infection. 

PDPT is not recommended for:

• Partners who are pregnant
• Patients diagnosed with multiple STIs
• Patients or partners at high risk of HIV or other STIs such as men who have sex with men
• Patients at risk of partner violence

Is there guidance for PDPT?

Health authorities in Victoria, New South Wales and the Northern Territory have provided guidance for PDPT. 

• Click here for information for Victoria
• Click here for information for New South Wales
• Click here for information about the Northern Territory
  

There is no health authority guidance for PDPT in other Australian jurisdictions. However a review of the PDPT policy environment⁵ found that PDPT is potentially allowable under relevant prescribing regulations in Western Australia, Tasmania, Australian Capital Territory, and South Australia (noting that PDPT is not recommended in South Australia due to concerns about azithromycin resistant gonorrhoea. You can read more about the South Australian context here). 

How do I do PDPT?

PDPT can be offered at the discretion of the clinician as part of the discussion with their patient about options for informing their partners. 

A flow chart for the process of offering and providing PDPT is available in our recent Australian Journal of General Practice article (available here). 

When PDPT is accepted the clinician will need to:

• Record in their patient’s medical record that PDPT was offered and accepted along with the partner’s details
• Prescribe Azithromycin 1g orally for the index patients partner/s.
• Provide information about PDPT for their patient and the patients partner/s
• Advise their patient to abstain from sex for seven days after taking the antibiotics.

Generating a PDPT prescription

If the partner is an existing patient of your clinic, the PDPT prescription can be generated from and documented in the partners medical record. 

If the partner is NOT an existing patient of your clinic the PDPT prescription can be:

• Handwritten on a prescription pad or prescription paper
• Populated from a PDPT prescription template (see PDPT workflow resources below for these. Note that the PDPT prescription templates can be imported into the letters section of the electronic medical software then generated from the index patient's medical record). 

Resources to support implementation of PDPT into practice are provided below, including prescription templates.

Where do I go for more information?

The Australasian Contact Tracing Guidelines have further information about PDPT. You can also check with your local health department or specialist sexual health centre.