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Physician nonadherence with a hepatitis C screening program.

William N Southern1, Mari-Lynn Drainoni, Bryce D Smith

  • 1Department of Medicine (Drs Southern and Litwin), Division of Hospital Medicine (Dr Southern), Division of General Internal Medicine (Dr Litwin), and Department of Family and Social Medicine (Dr McKee), Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York; Department of Health Policy & Management, Boston University School of Public Health, Boston, Massachusetts (Drs Drainoni, Christiansen, and Gifford and Ms Koppelman); Department of Medicine (Drs Drainoni and Gifford), Division of General Internal Medicine (Dr Gifford), Section of Infectious Diseases (Dr Drainoni), Boston University School of Medicine, Boston, Massachusetts; Center for Health Quality, Outcomes and Economic Research, ENRM Veterans Administration Hospital, Bedford, Massachusetts (Drs Drainoni, Christiansen, and Gifford and Ms Koppelman); and Division of Viral Hepatitis, National Center for HIV/Viral Hepatitis/STD/TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (Drs Smith and Weinbaum).

Quality Management in Health Care
|December 26, 2013
PubMed
Summary
This summary is machine-generated.

Hepatitis C virus (HCV) screening adherence was low at 36.1% despite a continuous intervention. Adherence varied significantly among physicians and declined over time, highlighting implementation challenges.

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Area of Science:

  • Hepatology
  • Infectious Diseases
  • Public Health

Background:

  • Hepatitis C virus (HCV) screening is recommended for at-risk patients.
  • Provider adherence to HCV testing guidelines remains unclear.
  • A multifaceted continuous intervention was implemented to improve adherence.

Purpose of the Study:

  • To measure adherence to an HCV screening protocol.
  • To identify patient, physician, and visit-level predictors of adherence.

Main Methods:

  • Prospective cohort study design.
  • Inclusion of 8981 patients and 154 physicians across 3 clinics.
  • Measurement of HCV screening protocol adherence and associated characteristics.

Main Results:

  • Overall adherence rate was 36.1%.
  • Factors associated with adherence included male sex, new patient status, morning visits, and non-English preferred language.
  • Significant variation in adherence among physicians (0%-92.4%) and a decline from 59.1% to 13.7% over 15 weeks.

Conclusions:

  • Adherence to HCV screening protocols is suboptimal.
  • Physician-level factors and implementation strategies significantly impact adherence.
  • Addressing physician barriers is crucial for effective guideline implementation.