Physician Adherence to Hepatitis C Screening Guidelines
JL Andrews DO, LB Weiss MS, D Brieir MS, G Scott DO
Rowan University School of Osteopathic Medicine, Department of Family Medicine, Stratford, NJ
HEPATITIS C
LECTURE
TOPICS
• US prevalence of HCV is 2.7-3.9 million
USPSTF GUIDELINES:
One Time Screening for HCV Infection in Adults Born
between 1945-1965 (Grade B)
• 75-85% infections become chronic
• People born from 1945-1965 are 27% of the US population
but are 75% of the US population with HCV
• Improved outcomes in treatment
• USPSTF HCV Screening Recommendations
• Appropriate Screening Lab: Anti-HCV AB
RESULTS
• Physician knowledge of USPSTF Birth Cohort Screening
Guidelines improved (Fig 1: 71.4% to 100%)
• 168 charts reviewed before lecture and 116 charts
reviewed after lecture from 7 physicians (Fig 2)
• Physician screening of patients born between 19451965 did not improve (p=0.181) (Fig 4)
(1):
(4):
ABSTRACT
Background and Hypothesis: There are approximately 5 million
people in the United States infected with Hepatitis C. Nearly 82%
of those people are part of the baby boomer generation.
Hepatitis C infection is currently the number one cause of liver
failure in the United States. The USPSTF recently updated their
guidelines to include a onetime screen for Hepatitis C for those
born between 1945-1965, due to the increased prevalence of
Hepatitis C in that population (Grade B). The researcher
hypothesized that review of USPSTF Hepatitis C Screening
Guidelines with physicians would improve appropriate screening
for patients born between 1945-1965.
Methods: An IRB approved study determined physician
knowledge about Hepatitis C screening guidelines both before
and after a lecture. Information provided included prevalence,
screening recommendations, and treatment options. Electronic
medical records of physicians who attended the lecture were
analyzed for appropriate screening in patients born between
1945-1965. This was completed both thirty days before and after
the lecture to determine if screening for Hepatitis C in the
patient population improved.
CHART SCREENING GUIDELINES
• Physician present at lecture completing both pre and
post questionnaire
• Physicians practice at one of two primary care offices
• Charts screened both 1 month before and after lecture
• Patient born between 1945-1965
• Patient present for well or health maintenance visit
• HCV screening ordered at current or previous visit
(2):
Results: Seven resident physicians participated in review of the
guidelines. Knowledge of screening guidelines improved from
71.4% to 100% after informative lecture. Charts of 168 patients
before the lecture and 116 patients after the lecture were
screened based on birth year. However, only 15% (n=25) and
19% (n=22) patients were screened respectively. Results showed
no significant change in screening the designated patient
population for Hepatitis C (p=0.181).
Conclusion: While physician knowledge of recommended
USPSTF screening guidelines for Hepatitis C for patients born
between 1945-1965 improved, the utilization of the
recommendation did not improve after the information was
presented. The authors recommend performing a subsequent six
month and one year review of medical records to assess whether
these physicians incorporated the guidelines into their practice.
Further recommendations for improving screening adherence
include direct patient education and reminders to be
incorporated into the EMR systems.
DISCUSSION & CONCLUSION
• Screening for HCV in patients born between
1945-1965 did not improve even though
physician knowledge improved
• Further recommendation include to
incorporate direct patient education and
utilizing EMR to remind physicians of
appropriate patients to screen.
REFERENCES
(3):
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