Physician nonadherence with a hepatitis C screening program

William N. Southern, Mari Lynn Drainoni, Bryce D. Smith, Elisa Koppelman, Melissa D. McKee, Cindy L. Christiansen, Allen L. Gifford, Cindy M. Weinbaum, Alain H. Litwin

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Testing for patients at risk for hepatitis C virus (HCV) infection is recommended, but it is unclear whether providers adhere to testing guidelines. We aimed to measure adherence to an HCV screening protocol during a multifaceted continuous intervention. Subjects and Methods: Prospective cohort design to examine the associations between patient-level, physician-level, and visit-level characteristics and adherence to an HCV screening protocol. Study participants included all patients with a visit to 1 of the 3 study clinics and the physicians who cared for them. Adherence to the HCV screening protocol and patient-level, physician-level, and visit-level predictors of adherence were measured. Results: A total of 8981 patients and 154 physicians were examined. Overall protocol adherence rate was 36.1%. In multivariate analysis, patient male sex (odds ratio [OR] = 1.18), new patient (OR = 1.23), morning visit (OR = 1.32), and patients'; preferred language being non-English (OR = 0.87) were significantly associated with screening adherence. There was a wide variation in overall adherence among physicians (range, 0%-92.4%). Screening adherence continuously declined from 59.1% in week 1 of the study to 13.7% in week 15 (final week). When implementing complex clinical practice guidelines, planners should address physician attitudinal barriers as well as gaps in knowledge to maximize adherence.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalQuality Management in Health Care
Volume23
Issue number1
DOIs
StatePublished - 2014

Fingerprint

Hepatitis C
contagious disease
physician
Physicians
Hepacivirus
Odds Ratio
sex ratio
multivariate analysis
Sex Ratio
Virus Diseases
Practice Guidelines
Language
Multivariate Analysis
Guidelines
language

Keywords

  • Clinical practice patterns
  • community-based participatory research
  • guideline adherence
  • hepatitis C
  • intervention studies
  • mass screening

ASJC Scopus subject areas

  • Health Policy
  • Care Planning
  • Health(social science)
  • Leadership and Management
  • Medicine(all)

Cite this

Southern, W. N., Drainoni, M. L., Smith, B. D., Koppelman, E., McKee, M. D., Christiansen, C. L., ... Litwin, A. H. (2014). Physician nonadherence with a hepatitis C screening program. Quality Management in Health Care, 23(1), 1-9. https://doi.org/10.1097/QMH.0000000000000007

Physician nonadherence with a hepatitis C screening program. / Southern, William N.; Drainoni, Mari Lynn; Smith, Bryce D.; Koppelman, Elisa; McKee, Melissa D.; Christiansen, Cindy L.; Gifford, Allen L.; Weinbaum, Cindy M.; Litwin, Alain H.

In: Quality Management in Health Care, Vol. 23, No. 1, 2014, p. 1-9.

Research output: Contribution to journalArticle

Southern, WN, Drainoni, ML, Smith, BD, Koppelman, E, McKee, MD, Christiansen, CL, Gifford, AL, Weinbaum, CM & Litwin, AH 2014, 'Physician nonadherence with a hepatitis C screening program', Quality Management in Health Care, vol. 23, no. 1, pp. 1-9. https://doi.org/10.1097/QMH.0000000000000007
Southern, William N. ; Drainoni, Mari Lynn ; Smith, Bryce D. ; Koppelman, Elisa ; McKee, Melissa D. ; Christiansen, Cindy L. ; Gifford, Allen L. ; Weinbaum, Cindy M. ; Litwin, Alain H. / Physician nonadherence with a hepatitis C screening program. In: Quality Management in Health Care. 2014 ; Vol. 23, No. 1. pp. 1-9.
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