BASHH have recently updated guidelines as regards criteria for hepatitis B and C testing. Are patients accessing the service offered hepatitis B and C testing appropriately? Furthermore can this data be extrapolated to calculate potential cost reductions should audit data suggest overtesting.Methods
100 case notes SHHAPT coded as T6 from 2 local clinics were scrutinised as to whether testing followed BASHH guidelines. In addition 50 case notes were randomly selected to ascertain whether a T6 code should have been applied.Results
87/100 (87%) underwent hepatitis B testing of which 10/87(11%) were found to be inappropriate The reasons for testing in this 11% included sexual exposure in a low prevalence (mostly in Europe), saliva exposure, and a history of an ex-partner with multiple contacts – 38/100 underwent hepatitis C testing of which 14/38 (36%) were tested inappropriately—the reasons given included contact with men having sex with men(MSM) with no history of chemsex, contact with a HIV infected patient, sexual assault, sexual contact with an intravenous drug user and sexual exposure in Europe. In the audit of random selection of 50 casenotes- there were no cases of missed opportunities for hepatitis testing. Extrapolation of data showed that £1739 annually could be saved if all testing for hepatitis B and C was based on national guidance.Discussion
Given the proven overtesting in the audit, guidelines are to be reiterated to clinical staff. It is hoped that this would translate to costs savings on an overstretched service pathology budget.