S1091 Barriers to Hepatitis C Virus Testing According to Latest CDC Recommendations Among Trainees of Internal Medicine and Family Medicine at a Single Tertiary Academic Medical Center

Abstract

Introduction: Hepatitis C virus (HCV) infection is a major source of morbidity and mortality in the United States. Chronic HCV infections affect approximately 2.4 million Americans. In 2020, the CDC, USPSTF, and AASLD/IDSA recommend one-time opt-out testing for HCV in all adults aged 18 to 79 years irrespective of risk factors. We sought to measure Internal Medicine (IM) and Family Medicine (FM) residents’ perspective of HCV screening guidelines and barriers to routine testing. Methods: This survey was conducted at a single tertiary care academic health center comprised of IM and FM training programs. An electronic anonymous 41-question survey was distributed among the trainees between May to June 2021. We received a total of 32 (28.5%) responses out of 112 (70 IM and 42 FM) resident physicians using Redcap distribution tool for obtaining the responses. Results: Thirty-two (21 IM and 11 FM) surveys were completed. Seventeen (53%) trainees were aware of the current CDC recommendations for HCV testing and less than five (15.6%) residents reported routine testing for HCV based on CDC recommendations. The most common barriers for routine testing were competing priorities (41%), insufficient time (37%) and patient refusal (16%) (Figure 1a). The most common facilitators for routine testing were Electronic Medical Records reminders (31%), knowledge about current guidelines (25%), institutional ease of ordering (12.5%) and reminders from attending physicians (12.5%) (Figure 1b). Many of the residents fail to obtain history regarding risk factors for HCV transmission during their encounters (see Figure 1c). Majority of the residents strongly agreed to positive statements about HCV screening (Figure 1d). There were no significant differences in the knowledge about HCV screening among internal medicine and family medicine residents in the program (see Table 1). Conclusion: There are gaps in knowledge regarding testing for HCV according to CDC recommendations among IM and FM residents. A small proportion of trainees were performing routine testing. While competing priorities and lack of time remain significant barriers to testing, electronic medical record reminders and knowledge about current guidelines facilitate testing.Figure 1.: Results graph representing responses obtained from trainees from Internal Medicine and Family Medicine at a single tertiary medical center.Table 1.: Demographic Characteristics of the respondent trainees and HCV Testing awareness among trainees.