Improving Inpatient Screening for Hepatitis C: A Stepped-Wedge Randomized Clinical Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 7,634
- 试验地点
- 1
- 主要终点
- Change in percentage of eligible patients that receive HCV antibody screening
研究概览
简要总结
This study will use a stepped-wedge cluster randomized clinical trial to evaluate a health system initiative to set defaults in the electronic health record admission order set to nudge inpatient hepatitis C (HCV) screening.
详细描述
The hepatitis C virus (HCV) is the leading cause of liver transplant and hepatocellular carcinoma in the United States, but direct-acting antiviral medications are now available and can cure the disease in over 95% of those that are treated. The Centers for Disease Control and Prevention (CDC) estimate that 75% of all chronic HCV infections in the United States are among adults born between 1945 and 1965. The CDC and US Preventive Services Task Force (USPTF) therefore recommends birth cohort screening for all adults born in this time period. In 2016, the Commonwealth of Pennsylvania signed into law a requirement that all hospitalized patients born during this time period be offered HCV screening. In this study, a stepped-wedge cluster randomized clinical trial will be conducted to test the effect of defaulting HCV screening into the admission order set to improve screening rates.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Health Services Research
- 盲法
- Double (Investigator, Outcomes Assessor)
盲法说明
The principal study investigator and data analyst will not have knowledge of when the hospital sites are randomized to the intervention.
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Be admitted to the Hospital of the University of Pennsylvania (HUP) or Penn Presbyterian Medical Center (PPMC)
- •Born between 1945 and 1965
排除标准
- •Patients will be excluded if they have already received Hepatitis C screening or have been previously diagnosed with Hepatitis C.
研究组 & 干预措施
HCV Screening Default-1 Hospital Crossed Over
Upon entering the admission order set in the EHR clinicians will receive a default order for HCV screening for eligible patients. Clinicians will have the opportunity to opt-out and not order screening
干预措施: Nudge (Behavioral)
HCV Screening Default-2 Hospitals Crossed Over
Upon entering the admission order set in the EHR clinicians will receive a default order for HCV screening for eligible patients. Clinicians will have the opportunity to opt-out and not order screening.
干预措施: Nudge (Behavioral)
结局指标
主要结局
Change in percentage of eligible patients that receive HCV antibody screening
时间窗: 6 months
The change in the percentage of eligible hospitalized patients that receive HCV antibody screening
次要结局
未报告次要终点