An Electronic Health Record-based Intervention to Promote Hepatitis C Virus Testing Among Adults Born Between 1945 and 1965: A Cluster-randomized Trial.
Med Care
; 55(6): 590-597, 2017 06.
Article
in En
| MEDLINE
| ID: mdl-28288075
ABSTRACT
BACKGROUND:
The Centers for Disease Control and Prevention (CDC) recommends one-time hepatitis C virus (HCV) antibody testing for "Birth Cohort" adults born during 1945-1965.OBJECTIVE:
To examine the impact of an electronic health record (EHR)-embedded best practice alert (BPA) for HCV testing among Birth Cohort adults.DESIGN:
Cluster-randomized trial was conducted from April 29, 2013 to March 29, 2014. SUBJECTS ANDSETTING:
Ten community and hospital-based primary care practices. Participants were attending physicians and medical residents during 25,620 study-eligible visits. INTERVENTION Physicians in all practices received a brief introduction to the CDC testing recommendations. At visits for eligible patients at intervention sites, physicians received a BPA through the EHR to order HCV testing or medical assistants were prompted to post a testing order for the physician. Physicians in control sites did not receive the BPA. MAINOUTCOMES:
HCV testing; the incidence of HCV antibody positive tests was a secondary outcome.RESULTS:
Testing rates were greater among Birth Cohort patients in intervention sites (20.2% vs. 1.8%, P<0.0001) and the odds of testing were greater in intervention sites after controlling for imbalances of patient and visit characteristics between comparison groups [odds ratio (OR), 9.0; 95% confidence interval, 7.6-10.7). The adjusted OR of identifying HCV antibody positive patients was also greater in intervention sites (OR, 2.1; 95% confidence interval, 1.3-11.2).CONCLUSIONS:
An EHR-embedded BPA markedly increased HCV testing among Birth Cohort patients, but the majority of eligible patients did not receive testing indicating a need for more effective methods to promote uptake.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Mass Screening
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Hepatitis C, Chronic
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Electronic Health Records
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Health Promotion
Type of study:
Clinical_trials
/
Guideline
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Prognostic_studies
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Screening_studies
Limits:
Aged
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Female
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Humans
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Male
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Middle aged
Country/Region as subject:
America do norte
Language:
En
Journal:
Med Care
Year:
2017
Document type:
Article
Affiliation country:
Morocco
Country of publication:
EEUU
/
ESTADOS UNIDOS
/
ESTADOS UNIDOS DA AMERICA
/
EUA
/
UNITED STATES
/
UNITED STATES OF AMERICA
/
US
/
USA