000 03215nam a22005177a 4500
942 _cART
008 200902s20202020 xxu||||| |||| 00| 0 eng d
040 _aOvid MEDLINE(R)
099 _a32732681
245 _aIdentification of Risk Factors for Testing of Hepatitis C in Non-Birth Cohort Patients: Is Universal Screening Necessary?.
251 _aJournal of Addiction Medicine. 2020 Jul 20
252 _aJ Addict Med. 2020 Jul 20
190 _aSmart A
190 _aGeboy A
190 _aBasch P
190 _aNichols W
190 _aZeymo A
190 _aPerez I
190 _aHafeez M
190 _aFleisher I
190 _aFernandez S
190 _aFishbein D
100 _aBasch, Peter
656 _aMedStar Institute for Quality and Safety
100 _aZeymo, Alexander
651 _aMedStar Health Research Institute
651 _aMedStar Washington Hospital Center
100 _aFernandez, Stephen J
651 _aMedStar Heart & Vascular Institute
100 _aFishbein, Dawn
656 _aMedicine/Infectious Diseases
253 _aJournal of addiction medicine
520 _aOBJECTIVES: CDC reported that 45% of Hepatitis C (HCV) infected people denied known risk factors. Electronic health record RF-based, non-Birth Cohort (born outside of years 1945-1965) screening is challenging as risk factors are often input as nonsearchable data. Testing non-Birth Cohort patients solely based on risk factors has the potential to miss a substantial number of HCV infected patients. The aim was to determine the HCV antibody positive prevalence who would have been missed had providers only followed risk factor based screening recommendations.
520 _aMETHODS: A 1:3 case-control retrospective nested chart review was conducted. HCV risk factors and opioid prescriptions were manually abstracted from the Electronic Health Record; other variables were collected using Explorys. In July 2015 HCV screening data was collected on non-Birth Cohort patients who were HCV tested across MedStar Health, as a presumptive marker for high risk. Univariate and multivariate logistic regression models were utilized to determine HCV antibody positive predictors.
520 _aRESULTS: Eighteen (23%) HCV antibody positive and 123 (49%) HCV antibody negative had no identified risk factors; 6 (33%) HCV antibody positive reported risk factors only after a positive test result. There was a significant interaction between age over 40 and opioid prescription use; these groups were 11x more likely to be HCV antibody positive (CI95 1.6-74.8).
520 _aCONCLUSIONS: HCV testing solely based on presence of risk factors in non-Birth Cohort patients has the potential to miss a significant number of HCV antibody positive patients. Given patient- and provider-level barriers in elucidating risk factors, universal HCV antibody screening may be warranted.
022 _a1932-0620
857 _uhttps://dx.doi.org/10.1097/ADM.0000000000000702
657 _aJournal Article
024 _a10.1097/ADM.0000000000000702 [doi]
260 _saheadofprint
546 _aEnglish
260 _c2020
269 _fFY2021
999 _c8892