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Multifaceted intervention model tripled HCV screening rates

Results from a recent study showed that a multifaceted intervention including provider and patient education, electronic medical record-enabled best practice alert, and increased hepatitis C treatment capacity significantly increased hepatitis C screening.

“Using electronic health record with a best practice alert and provider education can reduce disparities in screening especially among those baby boomers engaged in care and among busy clinical providers,” Mamta K. Jain, MD, from the University of Texas Southwestern Medical Center, and colleagues wrote.

The study comprised a pre-intervention group of 48,755 baby boomers and a post-intervention group of 34,093 eligible patients. Approximately 10% of those in the pre-intervention group received screening, whereas 34.5% of those in the post-intervention group received screening.

While the overall screening rate was 26.8%, 70% of screening occurred after implementing the intervention model.

Multivariate analysis showed increased screening occurred particularly among older baby boomers, patients with primary care engagement, female providers, providers with larger panel sizes, and in academic clinics.

In an analysis of 20,517 baby boomers who overlapped the two groups, HCV screening was significantly higher during the post-intervention period compared with the pre-intervention period with approximately one of three patients undergoing screening.

The researchers also observed increased screening after implementing the intervention model among patients with a history of alcohol use and those who had one or more primary care visits. Risk-based screening continued to show success with higher HCV screening among patients with elevated alanine aminotransferase.

“Our intervention was particularly effective in patients who were engaged in primary care,” Jain and colleagues wrote. “While these patients are likely the easiest to link to treatment and benefit from initial screening efforts, it is clear that interventions must start to engage at-risk patients who are not routinely engaged in clinical care if we genuinely wish to eliminate HCV infection.” – by Talitha Bennett

Disclosure: Jain reports research support from Gilead Sciences, Janssen and Merck. Please see the full study for all other authors’ financial disclosures.