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Randomized Controlled Trial
. 2020 Aug;103(2):884-886.
doi: 10.4269/ajtmh.20-0041. Epub 2020 May 14.

A Best Practice Alert for Identifying Hepatitis B-Infected Patients

Malini B DeSilva  1   2 , Amy Kodet  1 , Patricia F Walker  1   2   3
Affiliations
Randomized Controlled Trial

A Best Practice Alert for Identifying Hepatitis B-Infected Patients

Malini B DeSilva et al. Am J Trop Med Hyg. 2020 Aug.

Abstract

We developed and evaluated the Global Health Wizard Hepatitis B Best Practice Alert (BPA) to increase primary care provider adherence to evidence-based guidelines for hepatitis B virus (HBV) infection screening in non-U.S.-born patients. We conducted a pilot study using nine clinics to test BPA effectiveness. Eligible patients were aged ≥ 12 years, from a country of origin with ≥ 2% HBV prevalence, had no electronic health record documentation of HBV screening, and were seen for primary care during July 2012-March 2013. The BPA triggered for > 4,500 patients and identified six previously unrecognized HBV-infected patients. The pilot project demonstrated BPA effectiveness and continued to be used at pilot clinics until 2018 and was expanded to additional clinics in 2019; 29 additional HBV-infected patients were identified. Although successful, BPA usage steadily decreased over time. Poor BPA usage limits the power to achieve the goal of improved population-based HBV screening.

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Figures

Figure 1.
Figure 1.
Screenshot of the Global Health Wizard Hepatitis B Best Practice Alert which allows providers to choose “Open SmartSet” or “Do Not Open.” This figure appears in color at www.ajtmh.org.
Figure 2.
Figure 2.
Hepatitis B screening cascade. Percentage of patients for whom each step in the hepatitis B screening cascade was complete from the point at which a healthcare provider opened the Global Health Wizard Hepatitis B Best Practice Alert to having a final positive screening test result, HealthPartners 2012–2018 (N = 919).
See this image and copyright information in PMC

References

    1. Rajbhandari R, Chung RT, 2014. Screening for hepatitis B virus infection: a public health imperative. Ann Intern Med 161: 76–77. - PubMed
    1. Patel EU, Thio CL, Boon D, Thomas DL, Tobian AAR, 2019. Prevalence of hepatitis B and hepatitis D virus infections in the United States, 2011–2016. Clin Infect Dis 69: 709–712. - PMC - PubMed
    1. Le MH, Yeo YH, Cheung R, Henry L, Lok AS, Nguyen MH, 2019. Chronic hepatitis B prevalence among foreign-born and U.S.-born adults in the United States, 1999–2016. Hepatology 71: 431–443. - PubMed
    1. Kowdley KV, Wang CC, Welch S, Roberts H, Brosgart CL, 2012. Prevalence of chronic hepatitis B among foreign-born persons living in the United States by country of Origin. Hepatology 56: 422–433. - PubMed
    1. Abara WE, Qaseem A, Schillie S, McMahon BJ, Harris AM; High Value Care Task Force of the American College of Physicians and the Centers for Disease Control and Prevention , 2017. Hepatitis B vaccination, screening, and linkage to care: best practice advice from the American College of Physicians and the Centers for disease Control and Prevention. Ann Intern Med 167: 794–804. - PubMed

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