Background:
Chronic hepatitis C virus (HCV) infection is a major cause for liver transplant and liver‐related deaths in the United States. Roughly 75% of those infected were born between 1945 — 1965 – the baby boomer population. New and effective treatments are currently available. The CDC and USPSTF recently recommended screening all patients in this birth cohort in order to increase screening and early detection of HCV. The aim of our quality improvement (QI) study was to determine the effect of targeted resident education on HCV screening in our ambulatory resident practice.
Methods:
We conducted a randomized, blinded study in the internal medicine resident clinic, which included 20 residents. All residents received a lecture by a gastroenterology (GI) fellow regarding HCV screening guidelines. Residents were then randomized to receive the lecture alone or the lecture plus targeted teaching. Targeted teaching consisted in a weekly email with the new HCV screening guidelines and a list of their scheduled patients who were eligible for screening. Screening rates and odds ratios for each group were calculated. Pre‐ and post‐interventions screening rates were compared using the pre‐intervention group as reference.
Results:
We screened 360 visits, 240 pre‐ and 120 post‐interventions. Both interventions combined increased the HCV screening rates by 250% (1.7% vs. 8.3%, p=0.02). The GI lecture alone resulted in a significant increase in screening (OR=10; 95%CI: 3‐38; p=.01). There was a non‐significant trend towards increased screening with GI lecture plus targeted teaching (OR=4; 95% CI: 1‐14; p=.056).
Conclusions:
Our pilot teaching intervention significantly improved HCV screening rates in the baby boomer population in our outpatient resident’s practice. Incorporating a lecture about the new HCV screening guidelines to the ambulatory educational curriculum may be a more effective and sustainable strategy to increase HCV screening rates among residents than a more personalized targeted teaching approach.