Details:

Alternative Title:
Med Care
Personal Author:
Federman, Alex D. ; Kil, Natalie ; Kannry, Joseph ; Andreopolous, Evie ; Toribio, Wilma ; ... More +
Federman, Alex D. ; Kil, Natalie ; Kannry, Joseph ; Andreopolous, Evie ; Toribio, Wilma ; Lyons, Joanne ; Singer, Mark ; Yartel, Anthony ; Smith, Bryce D. ; Rein, David B. ; Krauskopf, Katherine Less -
Description:
Background

The Centers for Disease Control and Prevention (CDC) recommends one-time hepatitis C virus (HCV) antibody testing for “Birth Cohort” adults born during 1945–1965.

Objective

To examine the impact of an electronic health record (EHR)-embedded best practice alert (BPA) for HCV testing among Birth Cohort adults.

Design

Cluster-randomized trial was conducted from April 29, 2013 to March 29, 2014.

Subjects and Setting

Ten community and hospital-based primary care practices. Participants were attending physicians and medical residents during 25,620 study-eligible visits.

Intervention

Physicians in all practices received a brief introduction to the CDC testing recommendations. At visits for eligible patients at intervention sites, physicians received a BPA through the EHR to order HCV testing or medical assistants were prompted to post a testing order for the physician. Physicians in control sites did not receive the BPA.

Main Outcomes

HCV testing; the incidence of HCV antibody positive tests was a secondary outcome.

Results

Testing rates were greater among Birth Cohort patients in intervention sites (20.2% vs. 1.8%, P < 0.0001) and the odds of testing were greater in intervention sites after controlling for imbalances of patient and visit characteristics between comparison groups [odds ratio (OR), 9.0; 95% confidence interval, 7.6–10.7). The adjusted OR of identifying HCV antibody positive patients was also greater in intervention sites (OR, 2.1; 95% confidence interval, 1.3–11.2).

Conclusions

An EHR-embedded BPA markedly increased HCV testing among Birth Cohort patients, but the majority of eligible patients did not receive testing indicating a need for more effective methods to promote uptake.


Subjects:
[+]
Aged Article Cluster Analysis Databases, Factual Electronic Health Records Female Health Promotion Hepacivirus Hepatitis C, Chronic Humans Male Mass Screening Middle Aged
Source:
Med Care. 55(6):590-597.
Pubmed ID:
28288075
Pubmed Central ID:
PMC5759753
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States
Place as Subject:
New York City, NY
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:ba0af395bc31efb1f9eaee550dfe9102df678126dab0267ef19111c691ef675d
Download URL:
https://stacks.cdc.gov/view/cdc/50775/cdc_50775_DS1.pdf
File Type:

Supporting Files

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