Compliance with referral for hepatitis C evaluation among veterans.

GOALS: The goals of this study were to quantify the rate and to identify predictors of compliance with outpatient hepatitis C evaluation. BACKGROUND: Challenges in hepatitis C management include patient compliance with multiple clinic visits, laboratory tests, and radiologic studies throughout the management of hepatitis C. However, the success of hepatitis C management begins with the patient's compliance with referral for hepatitis C evaluation. STUDY: The administrative databases and medical records of patients who were newly referred to the Durham Veterans Affairs Medical Center for hepatitis C evaluation between 2002 and 2004 were reviewed. RESULTS: A total of 376 veterans were identified as being newly referred to the Durham Veterans Affairs Medical Center gastroenterology and liver clinics for hepatitis C evaluation. The mean age of referred patients was 51.2+/-6.1 years, and 94.7% were men. The majority of patients (87%) were compliant with referral for hepatitis C evaluation. In multivariable logistic regression adjusting for age, race, marital status, history of psychiatric disease, history of substance abuse, origin of referral, and wait time, keeping other outpatient appointments was a significant predictor of compliance with referral for hepatitis C evaluation (odds ratio 6.00; 95% confidence interval 1.52, 23.67). CONCLUSIONS: Veterans have a high rate of compliance with referral for hepatitis C evaluation, and their compliance is likely reflective of their motivation to maintain general health care. Future studies assessing other factors, such as patient educational level and socioeconomic status, may help to elucidate more fully the factors impacting compliance with hepatitis C management.

Duke Scholars

Author Carla Wheaton Brady Medicine, Gastroenterology

Author Cynthia Jan Coffman Biostatistics & Bioinformatics, Division of Biostatistics