Hepatitis C Antibody Testing in a Commercially Insured Population, 2005–2014

Isenhour, Cheryl; Hariri, Susan; Hales, Craig M.; Vellozzi, Claudia

doi:10.1016/j.amepre.2016.12.016

Cited by 24 publications

(23 citation statements)

References 23 publications

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“…Our findings complement those of Cheryl Isenhaur and coauthors, who observed a 2.5-fold increase in hepatitis C virus antibody testing in the period 2005–14—with the greatest increases seen in the birth cohort. 13 Our findings also complement another analysis that demonstrated increases in hepatitis C testing among the birth cohort following the release of the 2013 US Preventive Services Task Force recommendation. 14 We note that there was a secular trend of increasing screening rates in the US population and in each age group before the CDC’s recommendation.…”

Section: Discussionsupporting

confidence: 79%

“…10–12 Analyses of national trends in hepatitis C testing have shown significant increases in testing among the birth cohort in the period following the recommendation change, 13,14 but the specific causal impact of this policy change on clinical practice has not been evaluated. Improvements in testing can lead to increased case finding, decreased hepatitis C transmission, and earlier initiation of antiviral treatment among infected persons, thus reducing morbidity and mortality related to hepatitis C. 15–17 We analyzed hepatitis C screening rates in the United States in the period 2010–14, using a strong quasi-experimental design to determine the causal impact of the 2012 recommendation on rates of testing among people with commercial insurance in the birth cohort.…”

mentioning

confidence: 99%

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Hepatitis C Testing Increased Among Baby Boomers Following The 2012 Change To CDC Testing Recommendations

et al. 2017

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In 2012 the Centers for Disease Control and Prevention recommended routine testing for hepatitis C for people born in the period 1945–65. Until now, the recommendation’s impact on hepatitis C screening rates in the United States has not been fully understood. We used an interrupted time series with comparison group design to analyze hepatitis C screening rates in the period 2010–14 among 2.8 million commercially insured adults in the MarketScan database. Hepatitis C screening rates increased yearly between 2010 and 2014, from 1.65 to 2.59 per 100 person-years. A 49 percent increase in screening rates among people born during 1945–65 followed the release of the recommendation, but no such increase was observed among adults born after 1965. The effect among the target population was sustained, and by twenty-four months after the recommendation’s release, screening rates had increased 106 percent. We conclude that the hepatitis C testing policy change resulted in significantly increased testing among the target population and may have decreased the magnitude of the hepatitis C epidemic.

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Section: Discussionsupporting

confidence: 79%

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confidence: 99%

Hepatitis C Testing Increased Among Baby Boomers Following The 2012 Change To CDC Testing Recommendations

et al. 2017

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“…These recommendations were endorsed by the United States Preventive Services Task Force (USPSTF) in June 2013 . Despite this endorsement, when screening decisions are left to individual health professionals, HCV testing rates among baby boomers have remained below 25% …”

Section: Introductionmentioning

confidence: 99%

“…electronic medical records, hepatitis C, liver function test, mass screening Despite this endorsement, when screening decisions are left to individual health professionals, HCV testing rates among baby boomers have remained below 25%. [5][6][7] Since the 2012 CDC screening recommendation, various approaches to increase HCV screening among baby boomers have been reported. Rates of screening as high as 83% were achieved in an urban academic emergency department using a universal testing protocol with a patient-specific opt-out option.…”

Section: Introductionmentioning

confidence: 99%

Impact of electronic reminder systems on hepatitis C screening in primary care

MacLean

Berger

Cangiano

et al. 2018

Journal of Viral Hepatitis

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Screening for hepatitis C virus (HCV) was recommended in 2012 by the Centers for Disease Control (CDC) for the population born between 1946 and 1965. Reminder systems are effective at promoting HCV screening, but the yield of positive tests among various population subgroups and the linkage to specialty HCV treatment is not well understood. We sought to determine: (i) the effect of the CDC recommendation alone, and the effect of an electronic medical record (EMR) reminder on the proportion of the population screened; (ii) the yield of positive HCV tests as screening strategies have evolved, and according to a patient's history of serum aminotransferase testing; (iii) the proportion of positive cases followed up for HCV treatment. This retrospective cohort study included 60 000 primary care patients at a northeast US academic medical centre serving an urban and rural population in which an EMR reminder was instituted in 2014. Results demonstrated an increase in proportion tested for HCV from 12% prior to the CDC recommendation to 37% after the reminder system. The yield of positive HCV antibody (HCV Ab) tests decreased from 7% in the "case-finding" era to 1.6% after the EMR reminder prompted screening of a lower risk population (P < .001). Patients with a history of abnormal aminotransferase tests had a fivefold higher rate of positive HCV Ab testing (6.7% vs 1.5%, P < .001). Ninety per cent of patients with confirmed HCV infection were seen in specialty care.

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“…Universal hepatitis C virus (HCV) screening of baby boomers has been introduced in many health care settings because this population is 5 times more likely to be infected with HCV . A recent study showed a 2.5‐fold increase in HCV screening among commercially insured baby boomer patients over 10 years . Similarly, another study demonstrated increased HCV screening from 1.09 to 2.53 per 100,000 person‐years after release of US Preventive Service Task Force (USPSTF) guidelines, with the most dramatic increase occurring in the Northeast compared to other regions of the country .…”

mentioning

confidence: 99%

Evaluation of a Multifaceted Intervention to Reduce Health Disparities in Hepatitis C Screening: A Pre‐Post Analysis

Jain

Rich

Ahn³

et al. 2019

Hepatology

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Hepatitis C virus (HCV) testing in persons born from 1945 to 1965 has had limited adoption despite guidelines, particularly among racial/ethnic minorities and socioeconomically disadvantaged patients, who have a higher prevalence of disease burden. We examined the effectiveness of a multifaceted intervention to improve HCV screening in a large safety‐net health system. We performed a multifaceted intervention that included provider and patient education, an electronic medical record–enabled best practice alert, and increased HCV treatment capacity. We characterized HCV screening completion before and after the intervention. To identify correlates of HCV screening, we performed logistic regression for the preintervention and postintervention groups and used a generalized linear mixed model for patients observed in both preintervention and postintervention time frames. Before the intervention, 10.1% of 48,755 eligible baby boomer patients were screened. After the intervention, 34.6% of the 34,093 eligible baby boomers were screened (P < 0.0001). Prior to the intervention, HCV screening was lower among older baby boomers and providers with large patient panels and higher in high‐risk subgroups including those with signs of liver disease (e.g., elevated transaminases, thrombocytopenia), human immunodeficiency virus–positive patients, and homeless patients. Postintervention, we observed increased screening uptake in older baby boomers, providers with larger patient panel size, and patients with more than one prior primary care appointment. Conclusion: Our multifaceted intervention significantly increased HCV screening, particularly among older patients, those engaged in primary care, and providers with large patient panels.

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Hepatitis C Antibody Testing in a Commercially Insured Population, 2005–2014

Cited by 24 publications

References 23 publications

Hepatitis C Testing Increased Among Baby Boomers Following The 2012 Change To CDC Testing Recommendations

Hepatitis C Testing Increased Among Baby Boomers Following The 2012 Change To CDC Testing Recommendations

Impact of electronic reminder systems on hepatitis C screening in primary care

Evaluation of a Multifaceted Intervention to Reduce Health Disparities in Hepatitis C Screening: A Pre‐Post Analysis

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