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Study finds troubling trends in hepatitis C screening, diagnosis and referral

crucial that they catch this infection early by asking about risk factors, ordering tests, and referring those who test positive for evaluation and treatment," says Lok. "And since primary care is a two-way street, patients need to know whether they might be at risk, and volunteer that information to their doctors so they can get help and find out how they can keep from spreading the disease."

Adds Shehab, "General physicians are being expected to screen for more and more diseases, and our results show we need to help them do that in a way that's both efficient and effective."

The study is one of the first of its kind, based on actual medical records from patients at several primary care sites. Lok and Shehab have also performed surveys of primary care physicians, and found that many reported they thought they did a good job of assessing patients for their hepatitis C risk and referring them for treatment.

The new study did not examine why a higher percentage of patients weren't tested based on risk factors, or what reasons - such as a patient's age or other health problems - might have kept an infected patient from getting a referral. The study also only reflects patients who had a hepatitis C test, and not those who weren't asked about or didn't offer risk factor information.

"Ideally, early diagnosis can be made if doctors ask about hepatitis C risk factors and patients answer honestly," says Lok. "We shouldn't wait until patients have symptoms, or until the infection has progressed, as treatment is often more effective if it's begun earlier."

"In addition, there are important potential benefits to the public at large of early diagnosis," Shehab adds. "These include the fact that hepatitis C patients may change behaviors and therefore reduce the risk of transmission to others, and the possibility that they may modify practices such as alcohol consumption that may alter the disease's progression."

Eighty percent of people infected with h
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
20-May-2001


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