Acceptability of automatic screening for viral hepatitis in an emergency department setting: patient and healthcare worker perspectives.

BACKGROUND

Screening for viral hepatitis by automatically ordering hepatitis B and C serology on blood samples already collected from patients presenting to the emergency department (ED) is a relatively novel concept, with modest costs involved.

AIM

The aim of this study was to determine patient and healthcare worker perspectives of automatic hepatitis screening at a large metropolitan hospital in Sydney, Australia.

METHODS

In this cross-sectional survey study, patients admitted via ED and ED healthcare workers (HCWs) were invited to participate. The primary outcome was the level of patient and HCW acceptability of an automatic hepatitis screening process. Secondary outcomes were patient and HCW knowledge of viral hepatitis, perceptions and barriers to ED hepatitis screening in the absence of an automatic process.

RESULTS

Ninety-two percent of 273 patients who participated in the survey wished to know their viral hepatitis status, and 82% found automatic hepatitis B and C testing acceptable as part of their ED blood work. HCWs surveyed (48) believed this strategy would increase testing, as most did not routinely interrogate patients for risk factors or other eligibility criteria for hepatitis testing, as the presenting ED complaint was their priority. Even when indications for testing based on current guidelines were present, few (32%) HCWs initiated testing.

CONCLUSION

Automatic viral hepatitis testing in ED is supported by the majority of patients and HCWs, and the latter believe it would increase testing rates. Increasing identification of patients with hepatitis, if accompanied by effective linkage to care, could facilitate World Health Organization elimination goals.