Implementation and Preliminary Results of an Emergency Department Nontargeted, Opt-out Hepatitis C Virus Screening Program

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
Elissa M Schechter-PerkinsBenjamin P Linas

Abstract

Emergency department (ED) visits provide an opportunity for hepatitis C virus (HCV) screening for patients who otherwise might not be tested. We report on a novel nontargeted, opt-out HCV screening and linkage-to-care (LTC) program implemented in an urban ED. This is a descriptive analysis from 3 months (November 2016-January 2017) of a nontargeted, opt-out ED HCV screening and LTC program among patients at least 13 years old undergoing phlebotomy for clinical purposes. A multipurpose best practice advisory (BPA) alerted providers to the program and generated order labels. For patients who authorized testing, specimens were drawn in the ED for HCV antibody (Ab) and reflex confirmatory RNA tests. Public health navigators attempted to contact RNA-positive patients and arrange outpatient visits. HCV Ab tests were performed on 3,808 patients, a 6,950% increase from preprogram. The proportion of HCV Ab test positivity was 13.2% (504/3,808, 95% confidence interval [CI] = 12.2%-14.3%) and of those 97.8% (493/504) had a follow-up RNA test performed. A total of 292 were confirmed positive for active infection, for an overall RNA positivity rate of 7.7% (95% CI = 6.8%-8.5%). Of those with active infection, 155 (53%) were outside the Cent...Continue Reading

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Citations

Aug 26, 2018·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Raj Vuppalanchi, Lindsay Yoder
May 28, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Eshan U PatelAaron A R Tobian
Apr 6, 2019·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Mamta K JainAmit G Singal
Aug 23, 2020·International Journal of Environmental Research and Public Health·James M DavisH Scott Swartzwelder
Apr 11, 2020·Journal of Clinical and Translational Hepatology·Cynthia J Tsay, Joseph K Lim
Nov 16, 2018·The Western Journal of Emergency Medicine·Carmen N BurrellIan B K Martin
Mar 27, 2020·Canadian Journal of Gastroenterology & Hepatology·Kelsey RaganMark G Swain
Sep 10, 2020·Revista da Escola de Enfermagem da U S P·Rodrigo Galvão Bueno GardonaMaria Lucia Gomes Ferraz
Nov 24, 2020·Journal of Primary Care & Community Health·Heather SperringElissa M Schechter-Perkins
Nov 17, 2020·Population Health Management·John R LitakerRichard Taylor
Aug 12, 2021·Infectious Diseases·Jessica Jennifer WentworthPeer Brehm Christensen

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