Primary care-based interventions are associated with increases in hepatitis C virus testing for patients at risk

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

Research output: Contribution to journalArticle

58 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)497-503
Number of pages7
JournalDigestive and Liver Disease
Volume44
Issue number6
DOIs
StatePublished - Jun 2012

Fingerprint

Hepacivirus
Primary Health Care
Parturition
Physicians
Hepatitis C
Antiviral Agents
Therapeutics

Keywords

  • Chronic hepatitis C
  • HCV
  • Primary care
  • Public health
  • Screening

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Primary care-based interventions are associated with increases in hepatitis C virus testing for patients at risk. / Litwin, Alain H.; Smith, Bryce D.; Drainoni, Mari Lynn; McKee, Melissa D.; Gifford, Allen L.; Koppelman, Elisa; Christiansen, Cindy L.; Weinbaum, Cindy M.; Southern, William N.

In: Digestive and Liver Disease, Vol. 44, No. 6, 06.2012, p. 497-503.

Research output: Contribution to journalArticle

Litwin, AH, Smith, BD, Drainoni, ML, McKee, MD, Gifford, AL, Koppelman, E, Christiansen, CL, Weinbaum, CM & Southern, WN 2012, 'Primary care-based interventions are associated with increases in hepatitis C virus testing for patients at risk', Digestive and Liver Disease, vol. 44, no. 6, pp. 497-503. https://doi.org/10.1016/j.dld.2011.12.014
Litwin, Alain H. ; Smith, Bryce D. ; Drainoni, Mari Lynn ; McKee, Melissa D. ; Gifford, Allen L. ; Koppelman, Elisa ; Christiansen, Cindy L. ; Weinbaum, Cindy M. ; Southern, William N. / Primary care-based interventions are associated with increases in hepatitis C virus testing for patients at risk. In: Digestive and Liver Disease. 2012 ; Vol. 44, No. 6. pp. 497-503.
@article{ca704ca31dd2499e8d488b2997964867,
title = "Primary care-based interventions are associated with increases in hepatitis C virus testing for patients at risk",
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.",
keywords = "Chronic hepatitis C, HCV, Primary care, Public health, Screening",
author = "Litwin, {Alain H.} and Smith, {Bryce D.} and Drainoni, {Mari Lynn} and McKee, {Melissa D.} and Gifford, {Allen L.} and Elisa Koppelman and Christiansen, {Cindy L.} and Weinbaum, {Cindy M.} and Southern, {William N.}",
year = "2012",
month = "6",
doi = "10.1016/j.dld.2011.12.014",
language = "English (US)",
volume = "44",
pages = "497--503",
journal = "Digestive and Liver Disease",
issn = "1590-8658",
publisher = "Elsevier",
number = "6",

}

TY - JOUR

T1 - Primary care-based interventions are associated with increases in hepatitis C virus testing for patients at risk

AU - Litwin, Alain H.

AU - Smith, Bryce D.

AU - Drainoni, Mari Lynn

AU - McKee, Melissa D.

AU - Gifford, Allen L.

AU - Koppelman, Elisa

AU - Christiansen, Cindy L.

AU - Weinbaum, Cindy M.

AU - Southern, William N.

PY - 2012/6

Y1 - 2012/6

N2 - 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.

AB - 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.

KW - Chronic hepatitis C

KW - HCV

KW - Primary care

KW - Public health

KW - Screening

UR - http://www.scopus.com/inward/record.url?scp=84860249270&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84860249270&partnerID=8YFLogxK

U2 - 10.1016/j.dld.2011.12.014

DO - 10.1016/j.dld.2011.12.014

M3 - Article

C2 - 22342471

AN - SCOPUS:84860249270

VL - 44

SP - 497

EP - 503

JO - Digestive and Liver Disease

JF - Digestive and Liver Disease

SN - 1590-8658

IS - 6

ER -