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Evaluation of a Multifaceted Intervention to Reduce Health Disparities in Hepatitis C Screening: A Pre-Post Analysis.
Jain, Mamta K; Rich, Nicole E; Ahn, Chul; Turner, Barbara J; Sanders, Joanne M; Adamson, Brian; Quirk, Lisa; Perryman, Patrice; Santini, Noel O; Singal, Amit G.
Affiliation
  • Jain MK; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX.
  • Rich NE; Parkland Health & Hospital System, Dallas, TX.
  • Ahn C; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX.
  • Turner BJ; Parkland Health & Hospital System, Dallas, TX.
  • Sanders JM; Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX.
  • Adamson B; Department of Internal Medicine, UT Health Science Center, San Antonio, TX.
  • Quirk L; Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX.
  • Perryman P; Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX.
  • Santini NO; Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX.
  • Singal AG; Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX.
Hepatology ; 70(1): 40-50, 2019 07.
Article in En | MEDLINE | ID: mdl-30950085
ABSTRACT
Hepatitis C virus (HCV) testing in persons born from 1945 to 1965 has had limited adoption despite guidelines, particularly among racial/ethnic minorities and socioeconomically disadvantaged patients, who have a higher prevalence of disease burden. We examined the effectiveness of a multifaceted intervention to improve HCV screening in a large safety-net health system. We performed a multifaceted intervention that included provider and patient education, an electronic medical record-enabled best practice alert, and increased HCV treatment capacity. We characterized HCV screening completion before and after the intervention. To identify correlates of HCV screening, we performed logistic regression for the preintervention and postintervention groups and used a generalized linear mixed model for patients observed in both preintervention and postintervention time frames. Before the intervention, 10.1% of 48,755 eligible baby boomer patients were screened. After the intervention, 34.6% of the 34,093 eligible baby boomers were screened (P < 0.0001). Prior to the intervention, HCV screening was lower among older baby boomers and providers with large patient panels and higher in high-risk subgroups including those with signs of liver disease (e.g., elevated transaminases, thrombocytopenia), human immunodeficiency virus-positive patients, and homeless patients. Postintervention, we observed increased screening uptake in older baby boomers, providers with larger patient panel size, and patients with more than one prior primary care appointment.

Conclusion:

Our multifaceted intervention significantly increased HCV screening, particularly among older patients, those engaged in primary care, and providers with large patient panels.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Mass Screening / Hepatitis C Type of study: Diagnostic_studies / Evaluation_studies / Guideline / Prognostic_studies / Risk_factors_studies / Screening_studies Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: En Journal: Hepatology Year: 2019 Document type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Mass Screening / Hepatitis C Type of study: Diagnostic_studies / Evaluation_studies / Guideline / Prognostic_studies / Risk_factors_studies / Screening_studies Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: En Journal: Hepatology Year: 2019 Document type: Article
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