Primary care-based interventions are associated with increases in hepatitis C virus testing for patients at risk

Dig Liver Dis. 2012 Jun;44(6):497-503. doi: 10.1016/j.dld.2011.12.014. Epub 2012 Feb 18.

Abstract

Background: An estimated 3.2 million persons are chronically infected with the hepatitis C virus (HCV) in the U.S. Effective treatment is available, but approximately 50% of patients are not aware that they are infected. Optimal testing strategies have not been described.

Methods: The Hepatitis C Assessment and Testing Project (HepCAT) was a serial cross-sectional evaluation of two community-based interventions designed to increase HCV testing in urban primary care clinics in comparison with a baseline period. The first intervention (risk-based screener) prompted physicians to order HCV tests based on the presence of HCV-related risks. The second intervention (birth cohort) prompted physicians to order HCV tests on all patients born within a high-prevalence birth cohort (1945-1964). The study was conducted at three primary care clinics in the Bronx, New York.

Results: Both interventions were associated with an increased proportion of patients tested for HCV from 6.0% at baseline to 13.1% during the risk-based screener period (P<0.001) and 9.9% during the birth cohort period (P<0.001).

Conclusions: Two simple clinical reminder interventions were associated with significantly increased HCV testing rates. Our findings suggest that HCV screening programs, using either a risk-based or birth cohort strategy, should be adopted in primary care settings so that HCV-infected patients may benefit from antiviral treatment.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • African Americans / statistics & numerical data
  • Aged
  • Analysis of Variance
  • Chi-Square Distribution
  • Cross-Sectional Studies
  • European Continental Ancestry Group / statistics & numerical data
  • Female
  • Hepacivirus*
  • Hepatitis C, Chronic / diagnosis*
  • Hepatitis C, Chronic / virology
  • Hispanic Americans / statistics & numerical data
  • Humans
  • Insurance, Health / statistics & numerical data
  • Male
  • Mass Screening / statistics & numerical data*
  • Middle Aged
  • New York City
  • Primary Health Care / statistics & numerical data*
  • Program Evaluation
  • Reminder Systems*
  • Risk Factors
  • Urban Health Services / statistics & numerical data*