# Presentation: 277288

## Legal Status of Patient Delivered Partner Therapy (PDPT) in the U.S.: a National Survey of State Pharmacy Boards and Boards of Medical Examiners

- Uzoeshi Anukam MSII
- Center for AIDS & STD, University of WA
- Howard University College of Medicine

## Background

-   Patient delivered partner therapy (PDPT) is the practice of giving patients diagnosed with a curable STD medication to give to their sex partner(s)
-  Approximately 50% of clinicians in the U.S. report having given a patient with gonorrhea or chlamydial infection medication for a partner
-  PDPT has been shown to decrease reinfection rates in persons with gonorrhea in a RCT, and two RCTs have observed trends toward lower rates of recurrent or persistent CT in persons given PDPT
-  The legal status of PDPT in the U.S. is ill-defined

## Objective & Methods

-   Objective: To define whether PDPT is legal in the U.S.
-  Survey of directors of state boards of medicine and pharmacy
-      in 50 states & the District of Columbia
-  5 questions:
-  Is PDPT legal?
-  Has the issue ever been addressed?
-  What organization is responsible for deciding if PDPT is
-       legal?
-  Would a new law be required to make PDPT legal?
-  Would the board take disciplinary action against a provider
-      who employed PDPT?

## Response rate

- Medical Board
- Pharmacy Board
- Either medical or pharmacy board

- _Any response_
- 39 (76)
- 44 (86)
- 49 (96)

- _Data_
- 34 (67)
- 41 (80)
- 47 (92)

## Is PDPT Legal?

- Legal
-   Yes
-   No
-   Law is vague
-   Don’t Know
- Ever addressed
-   Yes
-   No
-   Don’t know

- Pharmacy Board
- _N (%)_
- 4 (10)
- 20 (49)
- 6 (15)
- 11 (27)
- 6 (15)
- 21 (51)
- 14 (34)

- Medical Board
- _N (%)_
- 5 (15)
- 14 (41)
- 5 (15)
- 10 (29)
- 7 (21)
- 16 (47)
- 11 (32)

## Legality of PDPT 

- Legal
- Illegal
- Unknown
- White = No response
- Disagreement med & pharm boards

- Legality of PDPT

## Frequency of whether the issue of PDPT had ever been addressed by medical or pharmacy boards by perceived legal status 

- _Legal in state_
-   Yes
-   No
-   Law is vague
-   Don’t Know

- Pharmacy Board
- (n=41)
- _N (%)_
- 2 (50)
- 4 (20)
- 0
- 0

- Medical Board
- (n=34)
- _N (%)_
- 4 (80)
- 1 (7)
- 1 (20)
- 1 (10)

## Agency responsible for deciding if PDPT is legal among areas in which practice was not considered legal

- _Agency_
-   Medical board
-   Pharm board
-   Dept. Health
-   Attorney general
-   State legislature
-   Don’t know

- Pharmacy Board
- (n=37)*
- _N (%)_
- 21 (57)
- 8 (22)
- 7 (19)
- 1 (3)
- 2 (5)
- 3 (8)

- Medical Board
- (n=29)*
- _N (%)_
- 15 (51)
- 9 (31)
- 3 (10)
- 3 (10)
- 0
- 6 (20)

- * 5 pharmacy boards and 7 medical boards indicated more than one agency would share responsibility

## Would a new law be required?

- Percent

## Would enforcement action be taken?

- Percent

## Summary

-   PDPT is clearly defined as being legal in 4 states (CA, WA, CO, TN).
-  Two (CA, TN) have specific laws on PDPT, and 2 (CO, WA) have written ruling on the issue without specific laws.
-  The legal status of PDPT in most other areas is ill-defined
-  Many boards of pharmacy & medicine regard PDPT as illegal, though most have never addressed the issue.
-  Some believe persons prescribing PDPT could be subject to legal action
-  Most boards of pharmacy & medicine believe new laws would be required to clearly establish the practice as being lawful.

## Conclusions

-   Although PDPT is common throughout the U.S. and several studies suggest the practice can improve partner notification outcomes, the legal status of PDPT is ill-defined and the practice if often considered unlawful.
-  If PDPT is to be promoted nationally, it will need to be explicitly defined as being legal.
-  This will likely require new laws or written rulings from relevant professional, legal or public health agencies.

## Contributors & Support

- _Center for AIDS & STD, UW_
- Matthew R. Golden
- H. Hunter Handsfield
- _WA State Pharmacy Board_
- Donald Williams

- _Support_
- UW NIH STD CRC AI31448
- NIAID K23 AI01846-02.