Background

European guidelines recommend routine testing in healthcare settings in areas with a high prevalence of blood borne viruses (HIV, HBV, and HCV).

Emergency departments provide a unique opportunity with their open-access care to large and diverse patient populations, including those at higher risk for BBVs, who otherwise have limited contact with routine health services.

European evidence shows that routine opt-out testing in emergency departments, where patients are informed that testing will be performed unless they decline, is highly effective in increasing testing uptake and identifying previously undiagnosed infections. This approach reaches individuals who may not otherwise be tested, including those with no prior testing history and those who do not present with recognised risk factors or indicator conditions. This approach also facilitates the re-engagement of previously diagnosed individuals who have disengaged from care.

Methodology

The development of this implementation guidance was coordinated by EuroTEST with the support of a multidisciplinary expert advisory group convened for this activity supervising both the development process and the content of the guidance.

Through thematic workstreams key topics for implementation were defined to guide a rapid literature review. To structure the evidence synthesis, the evidence base was compiled by developing decision-making tables under each guidance subtopic. Decision making tables and collected best practices were reviewed by the advisory group which provided expert recommendations resulting in a number of consensus practice recommendations for implementation of BBV opt-out testing in EDs.