Ned Snyder, MD, Curtis Curry, BA, Leon Jerrels, RN, MBA
Kelsey-Seybold Clinic, Houston, TX
Introduction: The World health Assembly has set as a goal the elimination of hepatitis C (HCV) as a public health threat by 2030. In the United States, a problem with elimination of HCV is that many patients that are infected are not identified, and the majority who screen positive for HCV, for a variety of reasons, do not receive treatment. In Texas, it has been estimated that only 25% of patients identified as infected actually receive treatment. The cost of treatment has decreased significantly, and lack of coordinated care may partially account for the low treatment rates. The majority of patients with chronic HCV were born 1945-1965, and it has been recommended that patients in this birth cohort be routinely screened with hepatitis c antibody. Kelsey-Seybold Clinic is an accountable health care organization that has about 1 1/2 million patient visits a year. At least 2/3's of the patients receive essentially all their care in our system. currently, there is a pop up message in the electronic medical records of patients in the 1945-1965 cohort when they are seen by their primary care physician as a reminder to check the HCV antibody if not previously done. We wanted to determine if this coordinated system led to a higher percentage of patients being treated than historically reported.
Methods: Utilizing the appropriate codes, we examined the data base for 2018 to see 1) what number of patients in this birth cohort with a positive HCV antibody had a HCV RNA performed 2) what number were referred for treatment 3)what number received treatment.
Results: A total of 8902 patients in the cohort were screened, and 136 (1.5%) were positive for HCV antibody. 113 of the 136 (83.1%) had a positive HCV RNA. At this time, 97 of the 113 have been seen by gastroenterology and hepatology and 85 have so far received anti-viral therapy for a treatment rate of 75.2%.At the time of presentation, updated treatment numbers and response rates will be available.
Discussion: Utilizing a system of coordinated care, we have been able to identify and a large number of patients in the 1945-1965 birth cohort, and subsequently treat a higher percentage of actively infected patients than has been previously noted.
Citation: Ned Snyder, MD, Curtis Curry, BA, Leon Jerrels, RN, MBA. P1516 - THE USE OF A "POP UP" IDENTIFICATION SYSTEM CAN LEAD TO THE IDENTIFICATION AND A HIGH PERCENTAGE OF TREATMENT OF PATIENTS WITH CHRONIC HEPATITIS C. Program No. P1516. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.