1. Primary care-based interventions are associated with increases in hepatitis C virus testing for patients at risk.
- Author
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Litwin AH, Smith BD, Drainoni ML, McKee D, Gifford AL, Koppelman E, Christiansen CL, Weinbaum CM, and Southern WN
- Subjects
- Adult, Black or African American statistics & numerical data, Aged, Analysis of Variance, Chi-Square Distribution, Cross-Sectional Studies, Female, Hepatitis C, Chronic virology, Hispanic or Latino statistics & numerical data, Humans, Insurance, Health statistics & numerical data, Male, Middle Aged, New York City, Program Evaluation, Risk Factors, White People statistics & numerical data, Hepacivirus, Hepatitis C, Chronic diagnosis, Mass Screening statistics & numerical data, Primary Health Care statistics & numerical data, Reminder Systems, Urban Health Services statistics & numerical data
- 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., (Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. All rights reserved.)
- Published
- 2012
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