Improving Hepatitis C Screening Rates in a Primary Care Setting
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Abstract
Hepatitis C Virus (HCV) is the most common blood borne infection in the United States and frequently develops into a chronic disease, which can lead to serious health complications including liver damage, cirrhosis, cancer, and death. Due to vague symptomology associated with HCV, half of people with chronic HCV are unaware of their condition. New HCV infections are most common in persons who inject drugs (PWID) and chronic infection is currently most prevalent in baby boomers (birth age 1945 to 1965).
The purpose of this project was to increase health care professionals’ comfort level and knowledge regarding HCV screening guidelines per USPSTF as well as to improve HCV screening rates for the PWID cohort and baby boomer cohort. This project was implemented when risk-based HCV screening was recommended. Many eligible patients do not undergo screening as nationally screening rates are low at 12.8%. Lack of time and knowledge deficit are common documented barriers that health care professionals identified throughout the literature that negate screening uptake.
This project was implemented by a multidisciplinary team utilizing the PDSA method. Two one-hour educational sessions were developed and provided to all health care professionals at two federally qualified health center primary care clinics in the Midwest region. The presentations were conducted by an infectious disease physician, a pharmacist who specializes in viral hepatitis, and the co-investigator in October 2019. Academic detailing occurred to follow-up and support health care professionals.
A voluntary, post-implementation survey was distributed to participants after the educational sessions and an abbreviated survey two months later. PWID and baby boomer and pre- and post-implementation screening rates were computed through the facility’s established process.
After this project, HCV screening rates increased by 16% for the baby boomer cohort and 5.5% for the PWID cohort. Health care professionals’ knowledge and confidence in HCV screening guidelines was enhanced through this intervention. With new updated universal HCV screening guidelines, continued efforts to screen for HCV is essential.