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A survey saw that of teenagers who sought care in the ED and were prescribed outpatient treatment, fewer than half who received an STI diagnosis filled their prescriptions.
Fewer than half of adolescents who receive a diagnosis of a sexually transmitted infection (STI) in an emergency department (ED) filled the prescriptions they were given, according to a telephone survey of teenagers who sought care in the ED and were prescribed outpatient treatment. Mean age of participants was 17.2 years; most were non-Hispanic Black, female, and publicly insured.
Interviewers used a standardized script to administer the survey, which consisted of multiple choice questions. Whereas 12 of 24 participants receiving STI treatment filled their prescriptions at the pharmacy, 10 returned to the ED for treatment (some patients who did not receive treatment in the ED were called back when laboratory results were positive), 2 patients were treated elsewhere, and 2 had no treatment. Fewer than one-third of patients with chlamydia filled their prescription at a pharmacy, compared with more than 75% of those with pelvic inflammatory disease. Interestingly, whereas all teenagers who filled their prescription at the pharmacy told their caregivers about their diagnosis, only half of those who returned to the ED did so.
Survey participants indicated that adhering to the recommended treatment posed challenges, including cost, transportation issues, lack of an insurance card, and knowing how to pick up a prescription. Asked their opinion about alternative ways to overcome obstacles to adherence, nearly all respondents expressed interest in using a mobile device, whereas school-based clinics inspired little interest.
Thoughts from Dr Farber
This is a problem in private practice as well as in the ED. Ask teenagers who need treatment if they anticipate having problems getting the prescription and have someone follow up with a phone call. Ensure you get their cell phone number so that you do not have to go through the family.
Sankar MG, Boyle MD, Badolato GM, Tran JQ, Lieberman A, Goyal MK. The adolescent experience of filling prescriptions for the treatment of sexually transmitted infections. J Pediatr Adolesc Gynecol. Published online December 24, 2021. doi:10.1016/j.jpag.2021.12.009