Effectiveness of a risk screener in identifying hepatitis C virus in a primary care setting

Abstract

Objectives: We evaluated an intervention designed to identify patients at risk for hepatitis C virus (HCV) through a risk screener used by primary care providers.

Methods: A clinical reminder sticker prompted physicians at 3 urban clinics to screen patients for 12 risk factors and order HCV testing if any risks were present. Risk factor data were collected from the sticker; demographic and testing data were extracted from electronic medical records. We used the t test, χ(2) test, and rank-sum test to compare patients who had and had not been screened and developed an analytic model to identify the incremental value of each element of the screener.

Results: Among screened patients, 27.8% (n = 902) were identified as having at least 1 risk factor. Of screened patients with risk factors, 55.4% (n = 500) were tested for HCV. Our analysis showed that 7 elements (injection drug use, intranasal drug use, elevated alanine aminotransferase, transfusions before 1992, ≥ 20 lifetime sex partners, maternal HCV, existing liver disease) accounted for all HCV infections identified.

Conclusions: A brief risk screener with a paper-based clinical reminder was effective in increasing HCV testing in a primary care setting.

FIGURE 1—

Clinical reminder sticker used in the risk screening intervention. Note. ALT = alanine aminotransferase; DK = don’t know; HCV = hepatitis C virus; LFT = liver function test; N/A = not applicable; PR = Puerto Rico.