ROCKVILLE, Md., April 6, 2016 /PRNewswire/ -- A new screening approach developed by Kaiser Permanente has been shown to close gaps in diagnosis and care for patients with the hepatitis C virus, according to new research published in the journal Clinical Infectious Diseases. The screening protocol could improve disease detection for the more than 1.5 million Americans who do not know they are chronically infected with the virus.
Hepatitis C is a viral infection that causes liver disease and inflammation of the liver. Three to 4 million individuals in the United States are chronically infected with the virus, according to the National Health and Nutrition Examination Survey. However, an estimated 50 percent to 80 percent of those individuals are unaware of their infection, increasing both the likelihood they will develop liver damage and the chances they will infect others. If left untreated, approximately 50 percent of those with chronic hepatitis C virus will develop liver cirrhosis and 33 percent will die from liver-related complications. Screening is recommended for all at-risk patients, including individuals with HIV or patients on kidney dialysis, and those born between 1945 and 1965. But despite outreach efforts, screening gaps persist.
"Chronic hepatitis C is a slowly progressing disease that is relatively asymptomatic until severe liver disease develops, which is why it is important to identify patients who may be at risk so we can coordinate timely treatment," said Michael Horberg, MD, executive director of research at the Mid-Atlantic Permanente Medical Group. "Our study shows the value of a comprehensive program to assist hepatitis C patients through each step of the care process, from screening to detection and monitoring."
In October 2014, Kaiser Permanente of the Mid-Atlantic States launched a comprehensive hepatitis C virus screening model designed to improve detection and treatment of the virus. The model has five primary components:
An automated electronic medical record best-practice alert to notify providers that patients are recommended for hepatitis C screening because they were born between 1945-1965 or they are identified as being at risk for the virus.
Automated confirmatory laboratory testing for any patient who tests positive for the hepatitis C virus antibody to determine whether or not the person has an active infection. This ensures the patient has a complete diagnosis.
A hepatitis C care coordinator to assist in ordering follow-up labs, scheduling liver damage testing, and informing patients of their infection status.
Integration of a noninvasive, pain-free test for measuring liver damage into the screening process.
Connection of patients to physicians for ongoing care.
Between October 2014 and July 2015, 11,200 patients were screened using this new protocol.
In the study related to the new protocol, researchers found:
A total of 3.25 percent tested positive for the hepatitis C virus antibody, and 100 percent of antibody-positive patients received subsequent hepatitis C virus RNA testing.
Of those patients who tested positive for the hepatitis C virus antibody, 75.9 percent had chronic hepatitis C virus, of which 80.8 percent underwent the non-invasive test to measure liver damage.
Hepatitis C virus diagnosis was communicated to 94 percent of patients.
To date, more than 30,000 Mid-Atlantic States patients have been screened for hepatitis C using the new protocol.
"As with any chronic disease, it is important to take a coordinated approach to care. There are many aspects of the Kaiser Permanente protocol that can be replicated by independent physicians or health systems," noted M. Cabell Jonas, PhD, study lead author and senior project manager at Kaiser Permanente. "The new hepatitis C care pathway enables broad screening in an efficient manner to ensure we are providing care to those who need it the most."
This study was funded by the Mid-Atlantic Permanente Medical Group.
Other authors of the study include Carla V. Rodriguez, PhD, MPH, with the Mid-Atlantic Permanente Research Institute, Jacquelyn Redd, MD, Dana A. Sloane, MD, Bradley J. Winston, MD, and Bernadette C. Loftus, MD, with the Mid-Atlantic Permanente Medical Group.
About Kaiser Permanente Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America's leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 10 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: kp.org/share