BBV_TestPrompt: testing a CDS system for prompted BBV testing
Research type
Research Study
Full title
BBV_TestPrompt Part 1: developing and testing a Clinical Decision Support application to prompt blood-borne virus testing
IRAS ID
231633
Contact name
David R Chadwick
Contact email
Sponsor organisation
South Tees Hospitals NHS Foundation Trust
Duration of Study in the UK
1 years, 0 months, 4 days
Research summary
Late diagnoses of HIV, hepatitis B and hepatitis C, the blood-borne viruses (BBV), remains high in the UK despite national guidelines and other efforts to increase testing. Late diagnosis is seen in 40% of new HIV diagnoses. Earlier diagnosis allows effective treatment (for HIV and hepatitis B) and cure of infection for hepatitis C, as well as reducing transmission of infections. Studies have found that patients with certain diseases associated with HIV have levels of undiagnosed HIV > 1/1000, where screening is cost-effective. Hence targetted HIV testing (and also hepatitis B/C testing) amongst patients with identified risk factors would not only lead to earlier diagnosis in those with undiagnosed BBV infections, but would be cost-effective.
Most patients who present with late HIV infection attend surgeries or hospitals in the year before diagnosis with symptoms suggestive of HIV, however are not tested. New approaches to increasing BBV testing are needed. Electronic patient record (EPR) systems provide an opportunity to prompt health care workers to perform BBV tests where blood tests and other EPR data indicate the patient may be at higher risk of undiagnosed BBV infection, via a clinical decision support (CDS) algorithm. The EPR system SystmOne (TTP) is widely used in Primary Care and some secondary care settings in North-East England and has the potential to prompt BBV tests.
The aim of this project is to test a new CDS application (BBV_TP1) initially in a pilot study in a small number of practices, to see how often the prompt comes up and what the best format of the prompt is to persuade doctors and nurses to respond to it. After adjustments, the prompt will then be tested formally in a larger group of practices to assess whether it improves BBV testing.REC name
HSC REC A
REC reference
18/NI/0146
Date of REC Opinion
28 Aug 2018
REC opinion
Unfavourable Opinion