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Primary care-based interventions are associated with increases in hepatitis C virus testing for patients at risk.

Litwin AH, Smith BD, Drainoni ML, McKee D, Gifford AL, Koppelman E, Christiansen CL, Weinbaum CM, Southern WN. Primary care-based interventions are associated with increases in hepatitis C virus testing for patients at risk. Digestive and Liver Disease : Official Journal of The Italian Society of Gastroenterology and The Italian Association For The Study of The Liver. 2012 Jun 1; 44(6):497-503.

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BACKGROUND: An estimated 3.2 million persons are chronically infected with the hepatitis C virus (HCV) in the U.S. Effective treatment is available, but approximately 50% of patients are not aware that they are infected. Optimal testing strategies have not been described. METHODS: The Hepatitis C Assessment and Testing Project (HepCAT) was a serial cross-sectional evaluation of two community-based interventions designed to increase HCV testing in urban primary care clinics in comparison with a baseline period. The first intervention (risk-based screener) prompted physicians to order HCV tests based on the presence of HCV-related risks. The second intervention (birth cohort) prompted physicians to order HCV tests on all patients born within a high-prevalence birth cohort (1945-1964). The study was conducted at three primary care clinics in the Bronx, New York. RESULTS: Both interventions were associated with an increased proportion of patients tested for HCV from 6.0% at baseline to 13.1% during the risk-based screener period (P < 0.001) and 9.9% during the birth cohort period (P < 0.001). CONCLUSIONS: Two simple clinical reminder interventions were associated with significantly increased HCV testing rates. Our findings suggest that HCV screening programs, using either a risk-based or birth cohort strategy, should be adopted in primary care settings so that HCV-infected patients may benefit from antiviral treatment.

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