Comparing Hepatitis C Virus Screening in Clinics Versus the Emergency Department

Abstract

Introduction: New evidence suggests that emergency department (ED)-based infectious diseases screening programs have utility. We aimed to compare clinic-based and ED-based hepatitis C virus (HCV) screening programs within a single health system, to identify key differences in HCV antibody (Ab) positivity and chronic HCV, as well as population demographics. Methods: In the clinic-based program, adults in the birth cohort (born 1945-1965) were screened for HCV. In the ED-based program, non-targeted HCV screening of all adults was conducted. We included patients screened between June 2019–June 2020. Patients were screened for anti-HCV Ab, and positive results were followed by HCV viral load (VL) testing. Our primary outcomes were seroprevalence of HCV Ab and HCV VL. Results: There were 1,296 and 12,778 patients screened for HCV in the clinics and the ED, respectively. In the clinic setting, 13 patients (1%) screened positive for HCV Ab and nine (69%) completed VL testing, which was positive in one patient (11%). In the ED, 1,053 patients (8%) screened positive for HCV Ab and 847 (80%) underwent reflex VL testing, which was positive in 381 patients (45%). In an ED birth cohort sub-analysis, Hepatitis C virus Ab seroprevalence was 15% (675/4521). Conclusion: In this study of patients in a single healthcare system, ED-based HCV screening was higher yield than clinic-based screening.

A pharmacist-led community-based survey study: Determining the impact of the Covid-19 pandemic on actionable factors associated with worse cancer outcomes and cancer health disparities

“…, 30. , 31 , 32 , 33 , 34 , 35. The motivational interviewing training which pharmacists receive provides them with another tool to help encourage heathier habits through behavior changes and further reduce cancer risk and risk of progression and/or recurrence.…”

“…, 30. , 31 , 32 , 33 , 34 , 35. Pharmacists already play a key role in helping mitigate worse cancer outcomes by providing smoking cessation counseling and dispensing smoking cessation medications, and studies have shown this has been effective in reducing smoking rates 30–32 .…”