1071 Awareness and Barriers to Hepatitis C Screening for Baby Boomers in Internal Medicine Training: A Nationwide Survey

Abstract

INTRODUCTION: World Health Organization has determined a goal of 65% reduction in Hepatitis C Virus (HCV) related mortality by 2030. Baby Boomers, born between 1945 to 1965, comprises two-thirds of patients with HCV in the United States (US). Despite one-time screening recommendation by CDC and USPTF, HCV screening remains low in this age group. There is no available data to determine the adherence and awareness of HCV screening in internal medicine (IM) training programs for this birth cohort. The objective of this study was to assess adherence, awareness, and barriers to hepatitis C screening among IM residents. METHODS: An electronic medical record query was made for HCV screening in patients, born between 1945 to 1965, and seen in IM resident continuity clinics from January 2018 to June 2019. Later, a national survey of the IM residents was conducted to assess the awareness and barriers to HCV screening. A convenience-based sampling method was adopted, and we created a 15-item survey instrument on REDCaP that was disseminated to residents by reaching out to their program directors/coordinators through email. RESULTS: A total of 1207 patients with mean age 62.2 years, and 49% of females met inclusion criteria; however, only 63 patients (4.9%) had their HCV status tested. In contrast to that, the results from 186 survey respondents showed that 73.7 % of residents are familiar with CDC recommendation to screen baby boomers for HCV. The respondents estimated to provide care to a mean of 54 ± 17 patients from this cohort per year in their continuity clinics. The participants also identified that patients who undergo screening; only 36% understands the purpose of the testing. Notably, survey respondents stated that 9.4% of patients associate HCV testing with IV drug use, suggesting potential stigmatization with testing. Most common barriers identified in the survey are knowledge gap (51.76%) at either patient or provider end, lack of EMR alerts (11.76%) and time constraints (9.4%) due to increased patient load, or complexity of the patients’ comorbidities. Nevertheless, 61% of the participants suggested that providers need more education and awareness about HCV screening in baby boomers. CONCLUSION: Adherence and awareness of HCV screening among Baby Boomers in IM residency training are low. There is a need to increase awareness and overcome these barriers to improve HCV testing in this vulnerable population.