An Electronic Health Record–based Intervention to Promote Hepatitis C Virus Testing Among Adults Born Between 1945 and 1965

A Cluster-randomized Trial

Datos Bibliográficos

ID9099360
AutoresAlex D Federman (0000-0002-4824-064X, Icahn School of Medicine at Mount Sinai, autor de correspondencia), Natalie Kil (Mount Sinai Health System, New York, NY), Joseph Kannry (0000-0002-6089-1488, Icahn School of Medicine at Mount Sinai, autor de correspondencia), Evie Andreopolous (Icahn School of Medicine at Mount Sinai), Wilma Toribio (0000-0001-9936-7811, Icahn School of Medicine at Mount Sinai, autor de correspondencia), Joanne Lyons (Mount Sinai Health System, New York, NY), Mark Singer (Mount Sinai Health System, New York, NY), Anthony Yartel (0000-0001-6586-9362, Centers for Disease Control and Prevention, Atlanta, GA), Bryce D Smith (0000-0002-7688-4602, Centers for Disease Control and Prevention, Atlanta, GA), David B Rein (0000-0002-1271-5789, NORC at the University of Chicago, Chicago, IL), Katherine Krauskopf (Valley Medical Group, Greenfield, MA)
Año2017
Volumen55
Número6
Páginas590-597
Fecha de publicación2017-06-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000715
PMID28288075
OpenAlexW2591942883
IdiomaEN
Citas recibidas3
Referencias citadas33

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

Cohort · Cohort study · Confidence interval · Family medicine · Hepatitis C · Hepatitis C virus · Incidence (geometry) · Medical record · Odds ratio · Virus · Diabetes Management and Education · Electronic Health Records Systems · Hepatitis C virus research · Immunology · Internal Medicine · Medicine · Pediatrics