Tess L. Petersen, MD, Jared Lander, DO, Elizabeth Richardson, DO, Megan Buckley, DO, Catherine Kuntz, MD, Gary Newman, MD; Lankenau Medical Center, Wynnewood, PA
Introduction: With advances in Hepatitis C Virus (HCV) infection treatment resulting cures in more than 95% of patients, primary care practices should be screening all patients born between 1945 and 1965 as indicated by the Centers for Disease Control and U.S. Preventive Services Task Force recommendations. The aim of this study is to determine whether increasing HCV screening in our primary care clinic increased referral to GI clinic and treatment for HCV. Methods: In our internal medicine residency clinic with an 80% inner-city population, HCV infographic campaign posters were hung throughout working areas to serve as both a visual reminder to screen patients and an education resource on who should be screened. A retrospective chart review was performed of visits from the 2016 calendar year (pre-intervention) and the 2017 calendar year (post intervention) for all patients born between 1945 and 1965. Screening rates were compared pre and post-intervention. From these data it was previously determined that hanging readily available CDC posters on HCV screening increased screening rates between 2016 and 2017. The present study expands on these data to determine whether increasing HCV screening increased referral to GI clinic and treatment for HCV. Of those who screened positive, data including time to referral to GI clinic, treatment regimen, and treatment outcome was collected to evaluate the efficacy of internal medicine clinic HCV screening and referral to GI clinic for treatment. Results: In this quality improvement study within our resident clinic, we found that hanging CDC posters on HCV screening increased screening rates from 27% to 38% between 2016 and 2017 respectively (P=0.006). 5 patients screened positive in 2016. Of these, 4 (80%) were referred to GI clinic and the fifth patient had negative PCR and thus did not require referral. One patient who screened positive followed up at a different center for treatment. 2 patients screened positive in 2017. Of these, 2 (100%) were referred to GI clinic. 3/7 were treated with glecaprevir/pibrentasvir and 2/7 were treated with elbasvir/grazoprevir. 5/7 who screened positive between 2016-2017 achieved sustained virologic response 24 weeks after completion of therapy. Discussion: Our study demonstrates that internal medicine residency clinics can increase Hepatitis C screening numbers by an easy, inexpensive method. Further, we demonstrate that by increasing screening we have increased the number of patients referred to GI and cured of HCV.
Disclosures: Tess Petersen indicated no relevant financial relationships. Jared Lander indicated no relevant financial relationships. Elizabeth Richardson indicated no relevant financial relationships. Megan Buckley indicated no relevant financial relationships. Catherine Kuntz indicated no relevant financial relationships. Gary Newman indicated no relevant financial relationships.