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Baby-Boomers May Be Underscreened for Hepatitis C

Many people who have hepatitis C do not know their disease status, this is especially true for Baby Boomers.

Baby boomers, people born between 1945 and 1965 have higher likelihood of being infected with HCV, mainly due to blood transfusions prior to discovery of HCV or due to IV drug use. National guidelines recommend screening of this population. Our research looked at hepatitis C virus (HCV) screening for patients born between 1945 and 1965, who were admitted by resident physicians to the internal medicine inpatient service at an urban community hospital between January 2014 to March 2015. We showed that there are resident physician barriers to HCV screening, that may be related to human error, oversight or electronic medical record deficiencies.

We conducted this research as a quality improvement project. We wanted to find out the rate of Hepatitis C screening—and, in addition, we wanted to focus on how many “baby boomers” were not tested and ascertain the reasons why. Our data showed that 75% of patients admitted to an inpatient internal medicine service who were eligible for birth-cohort HCV screening remained unscreened. Of those patients who were screened for HCV, we found a higher seroprevalence (5%) compared to the US general population (1.6 to 1.8%). What should readers take away from your report?

Dr. Patil: Lack of HCV screening represents a missed opportunity to link HCV-infected patients with potential cure. Continuing education of and vigilance by healthcare providers to conduct HCV screening in various settings (such as the emergency department, during inpatient admissions, etc.) and ensuring streamlined systematic implementation of hepatitis testing with linkage-to-care processes are paramount. What recommendations do you have for future research as a result of this study?

Dr. Patil: Additional research should be done after an in-service/focused training of the resident physicians and enhancement of the EMR admission/HCV screening process by the IT department. We anticipate conducting this next step of the quality improvement project, which includes conducting resident surveys pre- and post-intervention (i.e. in-service regarding HCV screening).

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