Exploring the acceptability of a ‘limited patient consent procedure’ for a proposed blood-borne virus screening programme: a Delphi consensus building technique

• Published in: BMJ open 2017-05, Vol.7 (5), p.e015373-e015373
• Main Authors: Crane, Denise, Henderson, Emily J, Chadwick, David R
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adult; Aged; AIDS; Algorithms; Consent; Delphi Technique; Diabetes; Emergency medical care; England; Ethics; Female; Health services; Hepatitis; Hepatitis B; Hepatitis C; Hepatitis, Viral, Human - epidemiology; HIV; HIV Infections - epidemiology; HIV/AIDS; Human immunodeficiency virus; Humans; Industrialized nations; Infections; Informed Consent - statistics & numerical data; Male; Mass Screening - methods; Mass Screening - psychology; Medical personnel; Medical practices; Medical tests; Middle Aged; Patient Acceptance of Health Care - statistics & numerical data; Patients; Primary care; Qualitative research; Social Stigma; Stigma; Surveys and Questionnaires; Systematic review; Viruses; Young Adult
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2016-015373

ObjectiveTo identify components of a proposed blood-borne virus (BBV) population screening programme and its associated consent procedure that both the public and health practitioners (HPs) would find acceptable. The proposed BBV screening system would aim to reduce late diagnosis of BBVs and be used in patients undergoing routine blood tests, aided by risk stratification software to target individuals at higher risk of infection.DesignA Delphi technique was used to build consensus among two separate groups, public participants and HPs in England.MethodsA survey incorporating vignettes was developed, with input from an external panel of experts. Over three rounds, 46 public participants and 37 HPs completed the survey, rating statements on a four-point Likert scale. The survey covered issues around stigma and sensitivity, the use of risk stratification algorithms and ‘limited’ patient consent (ie, preinformed of the option to ‘opt-out’). Consensus was defined as >70% of participants agreeing or disagreeing with each statement.ResultsConsensus was achieved among both groups in terms of acceptability of the screening programme. There was also consensus on using patient data to risk-stratify screening algorithms and the need to obtain some form of consent around the time of drawing blood.ConclusionsThis study found that the special protected status of HIV in England is no longer deemed necessary today and hinders appropriate care. We propose that a novel ‘limited consent procedure’ could be implemented in future screening programmes.