by Brian Palmer, 2016 Pharm.D.
candidate, Ferris State University College of Pharmacy
As
of Jan. 14, 2015, Expedited Partner Therapy (EPT) is legal in Michigan. For
readers who are unaware, EPT is the indirect treatment of a patient’s partner
who has been diagnosed with a sexually transmitted infection (STI) through
dispensing or prescribing of an antibiotic or other treatment that is the
standard of care for STIs according to the guidelines. If you knew about this,
you may have many questions just like I did. If you didn’t know about this, you
may have even more questions. In this post, I will summarize for you the
answers that I uncovered for the many questions I had such as:
- Who
qualifies for EPT?
- How
do I know which STIs this applies to?
- What
if the patient does not know their partner’s name?
- What
does this mean for pharmacists?
- What
is the pharmacist’s liability?
Know the Facts
Who qualifies for EPT and which STIs
are of concern?
Many
patients qualify for EPT. For instance, any patient who has an existing
relationship with a provider may inquire about EPT for their sexual partner(s).
In order for the partner to be covered, the patient has to have a laboratory
confirmed or suspected case of a STI. Specifically covered under this law are
gonorrhea and chlamydia. The Michigan Department of Health and Human Services
(MDHHS) is to distribute information about which STIs are covered, treatments
and warnings and precautions. To access more information, you may visit their
Web site online.
The patient must indicate that he or she has a partner who they have engaged in
sexual activity with 60 days prior to the diagnosis. There is no limit to the
amount of partners who are covered under the EPT law. The patient must also
indicate that his or her partner is unable or unwilling to get treatment within
a reasonable amount of time. The health professional does not have to have a
relationship with the partner to prescribe or dispense the medication. It
should be stressed to the patient that they should inform their partner of
their diagnosis and for them to seek medical examination and further treatment.
Men who have sex with men are not covered under EPT due to lack of demonstrated
efficacy and risk of missing STI/HIV co-infections. If abuse or assault is
suspected, EPT should not be used. In addition, pregnancy and EPT is of
concern, and should be considered last resort.
How could EPT prescriptions impact pharmacy?
Receiving
EPT prescriptions may be a little confusing at first. However, MPA has worked
with MDHHS to create best practices for pharmacists who receive EPT
prescriptions. Below you will find tips and resources. This guidance has not
been finalized, but we want you to be aware of upcoming changes.
What if the name of the partner is
unknown?
If the partner’s name is unknown, the
provider may dispense or prescribe to “Expedited Partner Therapy.” If this is
the case, the date of birth should be Jan. 1 of the current year.
What
does EPT mean for pharmacists?
Pharmacists should counsel patients to
inform their partner of a need for a complete STI evaluation and to read the
medication handout thoroughly. Pharmacists should be aware that the partner may
have an allergy to the medication and should address this with the patient. EPT
should be used as a last line in pregnancy, and so pharmacists should check to
make sure that pregnancy is not of concern. If pregnancy is possible, the
patient or partner should seek care from their provider. Counseling on
abstaining from sex for at least seven days after treatment is essential to
prevent reinfection. Pharmacists should advise patients to be reevaluated at
three months after treatment to rule out reinfection. It is important to note
that a pharmacist can change everything on the prescription for EPT except the
patient’s name, with consent from the doctor.
What liability does the pharmacist
have?
There is little to no liability,
unless gross negligence is suspected. The health professional who provides EPT
as authorized by law is not liable for damages in a civil court or subject to
administrative action for personal injury, death or other consequence arising
from or related in any way.
Online resources:
· If
you would like to read the law yourself, click here.
