BACKGROUND: Hepatitis B (HBV) induced hepatocellular carcinoma is the greatest cancer health disparity affecting Asian Americans, but the prevalence of screening to detect HBV is suboptimal. AIMS: Our aims were to determine the effectiveness of electronic health record (EHR) prompts to increase ordering of HBV tests among primary care providers (PCPs) within an academic health system. METHODS: We conducted a randomized, controlled trial between April and June 2011 among 76 PCPs caring for 175 outpatient adults with Chinese or Vietnamese surnames, with appointments with providers and no history of HBV testing. Providers were randomized to either receive an EHR prompt for HBV testing prior to patients' appointments or usual care. Primary outcomes were the proportion of patients (1) whose physician ordered a HBsAg test and (2) who completed testing. Secondary outcomes were (A) test results and (B) whether the physicians followed-up on the results. RESULTS:HBsAg tests were ordered for 36/88 (40.9 %) of the intervention patients and 1/87 (1.1 %) of the control patients [χ (2) (df = 1) = 41.48, p < 0.001]. Thirty intervention patients (34.1 %) and no control patients completed the HBsAg test [χ (2) (df = 1) = 35.80, p < 0.001]. Four (13.3 %) of the completed tests were HBsAg-positive, 14 (46.7 %) were immune, and 12 (40 %) were unprotected from HBV. Two HBsAg-positive patients were referred to specialists, and 3 unprotected patients were vaccinated for HBV. CONCLUSIONS: EHR-based provider prompts significantly increased HBV testing in Chinese and Vietnamese patients when compared to "usual care." EHR prompts are a promising intervention that could significantly increase screening for HBV.
RCT Entities:
BACKGROUND:Hepatitis B (HBV) induced hepatocellular carcinoma is the greatest cancer health disparity affecting Asian Americans, but the prevalence of screening to detect HBV is suboptimal. AIMS: Our aims were to determine the effectiveness of electronic health record (EHR) prompts to increase ordering of HBV tests among primary care providers (PCPs) within an academic health system. METHODS: We conducted a randomized, controlled trial between April and June 2011 among 76 PCPs caring for 175 outpatient adults with Chinese or Vietnamese surnames, with appointments with providers and no history of HBV testing. Providers were randomized to either receive an EHR prompt for HBV testing prior to patients' appointments or usual care. Primary outcomes were the proportion of patients (1) whose physician ordered a HBsAg test and (2) who completed testing. Secondary outcomes were (A) test results and (B) whether the physicians followed-up on the results. RESULTS: HBsAg tests were ordered for 36/88 (40.9 %) of the intervention patients and 1/87 (1.1 %) of the control patients [χ (2) (df = 1) = 41.48, p < 0.001]. Thirty intervention patients (34.1 %) and no control patients completed the HBsAg test [χ (2) (df = 1) = 35.80, p < 0.001]. Four (13.3 %) of the completed tests were HBsAg-positive, 14 (46.7 %) were immune, and 12 (40 %) were unprotected from HBV. Two HBsAg-positive patients were referred to specialists, and 3 unprotected patients were vaccinated for HBV. CONCLUSIONS: EHR-based provider prompts significantly increased HBV testing in Chinese and Vietnamese patients when compared to "usual care." EHR prompts are a promising intervention that could significantly increase screening for HBV.
Authors: Hueifang Chen; Shin-Ping Tu; Chong Z Teh; Mei-Po Yip; John H Choe; T Gregory Hislop; Victoria M Taylor; Beti Thompson Journal: J Community Health Date: 2006-04
Authors: Brian Custer; Sean D Sullivan; Thomas K Hazlet; Uchenna Iloeje; David L Veenstra; Kris V Kowdley Journal: J Clin Gastroenterol Date: 2004 Nov-Dec Impact factor: 3.062
Authors: Victoria M Taylor; Stephen M Schwartz; Yutaka Yasui; Nancy Burke; Jianfen Shu; D Hien Lam; J Carey Jackson Journal: J Community Health Date: 2004-12
Authors: Victoria M Taylor; Yutaka Yasui; Nancy Burke; Tung Nguyen; Anthony Chen; Elizabeth Acorda; John H Choe; J Carey Jackson Journal: Cancer Detect Prev Date: 2004
Authors: Roshan Bastani; Beth A Glenn; Annette E Maxwell; Angela M Jo; Alison K Herrmann; Catherine M Crespi; Weng K Wong; L Cindy Chang; Susan L Stewart; Tung T Nguyen; Moon S Chen; Victoria M Taylor Journal: Cancer Epidemiol Biomarkers Prev Date: 2015-06-23 Impact factor: 4.254
Authors: Grace X Ma; Carolyn Y Fang; Brenda Seals; Ziding Feng; Yin Tan; Philip Siu; Ming Chin Yeh; Sarit A Golub; Minhhuyen T Nguyen; Tam Tran; Minqi Wang Journal: Am J Public Health Date: 2017-01-19 Impact factor: 9.308
Authors: Moon S Chen; Dao M Fang; Susan L Stewart; May Ying Ly; Serge Lee; Julie H T Dang; Tram T Nguyen; Annette E Maxwell; Christopher L Bowlus; Roshan Bastani; Tung T Nguyen Journal: Cancer Epidemiol Biomarkers Prev Date: 2013-04-23 Impact factor: 4.254
Authors: Alex D Federman; Natalie Kil; Joseph Kannry; Evie Andreopolous; Wilma Toribio; Joanne Lyons; Mark Singer; Anthony Yartel; Bryce D Smith; David B Rein; Katherine Krauskopf Journal: Med Care Date: 2017-06 Impact factor: 2.983