The Role of Emergency and Primary Care in Combating the Rise of Gonorrhea: Another Purview Paradox?

Introduction: Drug-resistant Neisseria gonorrhoeae is an urgent threat to public health. Novel prevention and treatment strategies are emerging, including immunizations, pharmacologic post-exposure prophylaxis, rapid molecular resistance assays, and novel antibiotics. However, where and how such str...

Full description

Saved in:
Bibliographic Details
Published in:Journal of primary care & community health 2024-01, Vol.15, p.21501319241303609
Main Authors: Allan-Blitz, Lao-Tzu, Chan, Karly, Adamson, Paul, Klausner, Jeffrey D., Hsu, Katherine
Format: Article
Language:English
Subjects:
Adult
Anti-Bacterial Agents - therapeutic use
Drug Resistance, Bacterial
Emergency Service, Hospital - statistics & numerical data
Female
Gonorrhea - epidemiology
Gonorrhea - prevention & control
Humans
Interrupted Time Series Analysis
Male
Massachusetts - epidemiology
Neisseria gonorrhoeae
Original Research
Primary Health Care
Retrospective Studies
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Introduction: Drug-resistant Neisseria gonorrhoeae is an urgent threat to public health. Novel prevention and treatment strategies are emerging, including immunizations, pharmacologic post-exposure prophylaxis, rapid molecular resistance assays, and novel antibiotics. However, where and how such strategies are optimally implemented remains unclear. Methods: We conducted a retrospective interrupted time series analysis of gonorrhea cases reported to the Massachusetts Department of Public Health. We collected names of treating providers from 2011 (n = 100) and 2022 (n = 108), and cross-referenced provider names with publicly available records from the Massachusetts Boards of Registration in Medicine and Nursing to identify provider type, specialty, year of terminal degree or licensure, and clinic type. Results: Of 208 providers, 111 (53.4%) were advanced care practitioners. Providers treated cases predominantly in community health centers (n = 65, 31.3%) and emergency departments or urgent care centers (n = 60, 28.8%). Only 11 (12.4%) of 89 physicians were trained in either adult or pediatric infectious diseases. Conclusion: Our results indicate that the majority of gonorrhea cases in the Massachusetts are treated in non-specialty settings. The time is now to plan for implementation of the emerging strategies to avoid underutilization and assure uptake of interventions in settings positioned to reach persons diagnosed with gonorrhea who will benefit most.
ISSN:2150-1319
2150-1327
2150-1327
DOI:10.1177/21501319241303609