An Electronic Health Record-based Intervention to Promote Hepatitis C Virus Testing Among Adults Born Between 1945 and 1965: A Cluster-randomized Trial
| Autor: | Mark Singer, Alex D. Federman, Natalie Kil, Evie Andreopolous, Joseph L. Kannry, David B. Rein, Bryce D. Smith, Katherine Krauskopf, Joanne Lyons, Wilma Toribio, Anthony Yartel |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Databases Factual Hepatitis C virus Hepacivirus MEDLINE Health Promotion medicine.disease_cause Article law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Medicine Cluster Analysis Electronic Health Records Humans Mass Screening 030212 general & internal medicine Cluster randomised controlled trial Mass screening Aged biology business.industry Public Health Environmental and Occupational Health Hepatitis C Hepatitis C Chronic Middle Aged medicine.disease biology.organism_classification Health promotion 030211 gastroenterology & hepatology Female New York City business |
| Zdroj: | Medical care. 55(6) |
| ISSN: | 1537-1948 |
| Popis: | 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.To examine the impact of an electronic health record (EHR)-embedded best practice alert (BPA) for HCV testing among Birth Cohort adults.Cluster-randomized trial was conducted from April 29, 2013 to March 29, 2014.Ten community and hospital-based primary care practices. Participants were attending physicians and medical residents during 25,620 study-eligible visits.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.HCV testing; the incidence of HCV antibody positive tests was a secondary outcome.Testing rates were greater among Birth Cohort patients in intervention sites (20.2% vs. 1.8%, P0.0001) 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).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. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|