%0 Journal Article
%@ 1468-5833
%A Trelle, S.
%A Shang, A.
%A Nartey, L.
%A Cassell, J.A.
%A Low, N.
%D 2007
%F discovery:2491
%J BMJ
%N 7589
%P 354
%T Improved effectiveness of partner notification for patients  with sexually transmitted infections: systematic review
%U https://discovery.ucl.ac.uk/id/eprint/2491/
%V 334
%X Objective: To examine the effectiveness of methods to  improve partner notification by patient referral (index  patient has responsibility for informing sex partners of  their exposure to a sexually transmitted infection).  Design: Systematic review of randomised trials of any  intervention to supplement simple patient referral.  Data sources: Seven electronic databases searched  (January 1990 to December 2005) without language  restriction, and reference lists of retrieved articles.  Review methods: Selection of trials, data extraction, and  quality assessment were done by two independent  reviewers. The primary outcome was a reduction of  incidence or prevalence of sexually transmitted  infections in index patients. If this was not reported data  were extracted according to a hierarchy of secondary  outcomes: number of partners treated; number of  partners tested or testing positive; and number of  partners notified, located, or elicited. Random effects  meta-analysis was carried out when appropriate.  Results: 14 trials were included with 12 389 women and  men diagnosed as having gonorrhoea, chlamydia, nongonococcal  urethritis, trichomoniasis, or a sexually  transmitted infection syndrome. All studies had  methodological weaknesses that could have biased  their results. Three strategies were used. Six trials  examined patient delivered partner therapy. Metaanalysis  of five of these showed a reduced risk of  persistent or recurrent infection in patients with  chlamydia or gonorrhoea (summary risk ratio 0.73, 95%  confidence interval 0.57 to 0.93). Supplementing  patient referral with information for partners was as  effective as patient delivered partner therapy. Neither  strategy was effective in women with trichomoniasis.  Two trials found that providing index patients with  chlamydia with sampling kits for their partners  increased the number of partners who got treated.  Conclusions: Involving index patients in shared  responsibility for the management of sexual partners  improves outcomes. Health professionals should  consider the following strategies for the management of  individual patients: patient delivered partner therapy,  home sampling for partners, and providing additional  information for partners.