Physician Nonadherence With a Hepatitis C Screening Program

Details

• Alternative Title:
  Qual Manag Health Care
• Personal Author:
  Southern, William N. ; Drainoni, Mari-Lynn ; Smith, Bryce D. ; Koppelman, Elisa ; McKee, M. Diane ; Christiansen, Cindy L. ; Gifford, Allen L. ; Weinbaum, Cindy M. ; Litwin, Alain H.
• Description:
  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.
  
  
• Subjects:
  Adult Aged Ambulatory Care Facilities Analysis Of Variance Article Clinical Practice Patterns Cohort Studies Community-based Participatory Research Female Guideline Adherence Hepatitis C Humans Incidence Intervention Studies Logistic Models Male Mass Screening Middle Aged Patient Compliance Practice Patterns, Physicians' Predictive Value Of Tests Primary Health Care Program Evaluation Prospective Studies Risk Assessment Young Adult

  More +
• Source:
  Qual Manag Health Care. 23(1):1-9.
• Pubmed ID:
  24368717
• Pubmed Central ID:
  PMC5464610
• Document Type:
  Journal Article
• Funding:
  KL2 RR025749/RR/NCRR NIH HHS/United States ; UL1 RR025750/RR/NCRR NIH HHS/United States ; P30 AI051519/AI/NIAID NIH HHS/United States ; TL1 RR025748/RR/NCRR NIH HHS/United States ; P30AI51519/AI/NIAID NIH HHS/United States ; CC999999/Intramural CDC HHS/United States
• Volume:
  23
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:8177b8fa9f846d001b2f17084361f62ffa4055b7849d4425a27c5c3647c8ad95
• Download URL:
  https://stacks.cdc.gov/view/cdc/46142/cdc_46142_DS1.pdf
• File Type:
  [PDF - 414.10 KB ]