"During the initial ED visit, if a patient is getting empiric STI treatment, the patient is e-prescribed it. For the partner, because there is no health record for them the system, it is physically handwriten for them.

There is a pharmacy that's 24/7 associated with the ED and located next to the ED. The patient brings it there to be physically filled so they can take the medication to their partner.

If a patient is lab-confirmed positive following the visit, ED pharmacy has a collaborative practice agreement with the medical director to prescribe EPT post ED encounter under the medical directors name. The ED pharamacists calls the patient to determine if they would be candidates to offer EPT. If the patient wants to treat their partner, the ED pharmacist calls it into the patient's preferred pharmacy. The ED pharamacy is in the process of transitioning this task to outpatient pharmacy for the ED call-backs.

Additionally, there is a PrEP clinic where they screen for high risk patients. The call-back pharmacists introduces the idea of PrEP and then refers them to a screener who will reach out to the patient, and then calls the patient and decides whether or not they would come in and be eligible or not eligible. A positive STD test is the first level of screening that they could be a good candidate for PrEP.

This process has been in place for approximately seven years. About four to six patients are positive for an STI per day, and about two to four partner scripts are issued a day. Generally, when a patient is in a situation where they will be seeing their partner again, they accept the offer for EPT."

by Gabrielle Jacknin, PharmD, BCPS

Emergency Department Clinical Lead Pharmacist

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