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Randomized Controlled Trial
. 2013 Mar;58(3):807-14.
doi: 10.1007/s10620-012-2396-9. Epub 2012 Oct 17.

Electronic messages increase hepatitis B screening in at-risk Asian American patients: a randomized, controlled trial

Leeyen Hsu  1 , Christopher L Bowlus, Susan L Stewart, Tram Thanh Nguyen, Julie Dang, Brian Chan, Moon S Chen Jr
Affiliations
Randomized Controlled Trial

Electronic messages increase hepatitis B screening in at-risk Asian American patients: a randomized, controlled trial

Leeyen Hsu et al. Dig Dis Sci. 2013 Mar.

Abstract

Background: Hepatitis B (HBV) induced hepatocellular carcinoma is the greatest cancer health disparity affecting Asian Americans, but the prevalence of screening to detect HBV is suboptimal.

Aims: Our aims were to determine the effectiveness of electronic health record (EHR) prompts to increase ordering of HBV tests among primary care providers (PCPs) within an academic health system.

Methods: We conducted a randomized, controlled trial between April and June 2011 among 76 PCPs caring for 175 outpatient adults with Chinese or Vietnamese surnames, with appointments with providers and no history of HBV testing. Providers were randomized to either receive an EHR prompt for HBV testing prior to patients' appointments or usual care. Primary outcomes were the proportion of patients (1) whose physician ordered a HBsAg test and (2) who completed testing. Secondary outcomes were (A) test results and (B) whether the physicians followed-up on the results.

Results: HBsAg tests were ordered for 36/88 (40.9 %) of the intervention patients and 1/87 (1.1 %) of the control patients [χ (2) (df = 1) = 41.48, p < 0.001]. Thirty intervention patients (34.1 %) and no control patients completed the HBsAg test [χ (2) (df = 1) = 35.80, p < 0.001]. Four (13.3 %) of the completed tests were HBsAg-positive, 14 (46.7 %) were immune, and 12 (40 %) were unprotected from HBV. Two HBsAg-positive patients were referred to specialists, and 3 unprotected patients were vaccinated for HBV.

Conclusions: EHR-based provider prompts significantly increased HBV testing in Chinese and Vietnamese patients when compared to "usual care." EHR prompts are a promising intervention that could significantly increase screening for HBV.

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Figures

Figure 1
Figure 1
Follow-Chart Depicting Sequence and Outcomes of Electronic Prompting for HBV testing. Diagram of patient and provider eligibility and randomization. Providers were randomized prior to the first patient’s appointment. HBsAg: hepatitis B surface antigen; HBV: hepatitis B virus.
See this image and copyright information in PMC

References

    1. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. GLOBOCAN 2008 v1.2, Cancer Incidence and Mortality Worldwide: IARC Cancer Base No. 10 [Internet] Lyon, France: International Agency for Research on Cancer; 2010. [accessed Sep 24, 2011]. Available from URL: http://globocan.iarc.fr.
    1. Siegel R, Ward E, Brawly O, Jemal A. Cancer statistics, 2011: The impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin. 2011;61:212–36. - PubMed
    1. Miller BA, Chu KG, Hanley BF, Ries LA. Cancer incidence and mortality patterns among specific Asian and Pacific Islander populations in the U.S. Cancer Causes Control. 2008;19:227–56. - PMC - PubMed
    1. Chen MS., Jr Cancer health disparities among Asian Americans: what we do and what we need to do. Cancer. 2005;104:2895–902. - PubMed
    1. Chang ET, Keegan THM, Gomez SL, et al. The burden of liver cancer in Asians and Pacific Islanders in the Greater San Francisco Bay Area, 1990 through 2004. Cancer. 2007;109:2100–8. - PMC - PubMed

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