Not so fast, I am serofast: Using actionable patient education to drive appropriate management of people with serofast syphilis serologies.

An increase in syphilis cases in the United States and the global shortage of Benzathine Penicillin G (BPG) calls for evidence-based optimization. Confusing serologies and incomplete sexual history exacerbate the overprescription of BPG, especially for patients with "serofast" serologies.The aim of this project was to reduce unindicated BPG administration while maintaining or improving appropriate BPG administration in people diagnosed with syphilis.A longitudinal pre-post design was implemented where actionable education was delivered to patients who received BPG injection to treat syphilis.Benzathine Penicillin G was administered 187 times (69 preintervention, 118 postintervention), and inappropriate administration declined by 7.9% relatively (10.1-9.3%). There was no difference in outcomes between the newly infected and reinfected patients.This project demonstrated modest improvements in the administration of appropriate BPG, although the results did not reach statistical significance.Future interventions should focus on automating patient education within the electronic health record. The growing prevalence of syphilis among non-traditional risk groups emphasizes the importance of sexual health screening and educational approaches to enable patients to advocate for appropriate syphilis management, especially when they are serofast.

Duke Scholars

Author Dennis Kan School of Nursing

Author Jennie De Gagne School of Nursing