Challenges in managing patients in Australia with chronic hepatitis B: the General Practitioners’ perspective

Wallace, Jack; Hajarizadeh, Behzad; Richmond, Jacqui; McNally, Steve

doi:10.1111/1753-6405.12127

Cited by 25 publications

(30 citation statements)

References 21 publications

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“…The lack of representation of Aboriginal and Torres Strait Islander people in this study reflects the greater proportion © 2015 Public Health Association of Australia of this population living in rural and remote areas and highlights the challenges involved in access to CHB clinical management for these populations. 21,33 In conclusion, the current study identified hepatitis B knowledge gaps among people with CHB, particularly those with a low level of academic education, low English proficiency and older people. Comprehensive educational interventions using strategies and techniques shown to develop health literacy are needed to improve the capacity of people with CHB to respond to their infection.…”

Section: Discussionmentioning

confidence: 72%

“…[16][17][18] In a health professionals are a trusted source of information for people with CHB. 16,19 Educating people with CHB was identified by Australian GPs as an important responsibility in their clinical management 20 although systemic barriers have been identified in providing this support, given GPs' busy schedules and workloads, 21,22 and hepatitis B knowledge gaps among some GPs. 21,23 A study from one tertiary hospital liver clinic reported that clinicians did not provide detailed information about hepatitis B during most ongoing monitoring consultations.…”

Section: Discussionmentioning

confidence: 99%

“…16,19 Educating people with CHB was identified by Australian GPs as an important responsibility in their clinical management 20 although systemic barriers have been identified in providing this support, given GPs' busy schedules and workloads, 21,22 and hepatitis B knowledge gaps among some GPs. 21,23 A study from one tertiary hospital liver clinic reported that clinicians did not provide detailed information about hepatitis B during most ongoing monitoring consultations. 12 This study suggested that even if people with CHB were provided with detailed information upon diagnosis, ongoing education is still needed.…”

Section: Discussionmentioning

confidence: 99%

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Hepatitis B knowledge and associated factors among people with chronic hepatitis B

Hajarizadeh

Wallace

Richmond

et al. 2015

Australian and New Zealand Journal of Public Health

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Abstract:Objective: To assess hepatitis B knowledge among people with chronic hepatitis B (CHB) in Australia.Methods: People with CHB in three Australian jurisdictions completed a self-administered questionaire, including 24 hepatitis B knowledge questions across four domains: transmission; natural history; epidemiology and prevention; and clinical management.Results: Ninety-three people completed the survey. Mean age was 45 years, 43% were women and 93% were born overseas (75% from Asia). Mean total knowledge score was 55 out of 100 with 17 participants (18%) scoring ≥75 (defined as a high knowledge). Clinical management scored the lowest (median: 25) and natural history scored the highest (median: 80). In adjusted linear regression, tertiary education (vs. secondary and under) was associated with higher knowledge score (β: 11.95; 95%CI: 2.45, 21.44; p=0.01). In adjusted logistic regression, very good English proficiency (vs. limited/no proficiency) was associated with high knowledge (OR: 7.65; 95%CI: 1. 94, 30.19; p<0.01). Participants reporting hepatitis B-related anxiety demonstrated a significantly higher knowledge score compared to those reporting no such anxiety (β: 15.11; 95%CI: 4.40, 25.81; p<0.01). Conclusions and implications:Hepatitis B-related knowledge gaps were identified among people with CHB. Interventions to improve knowledge should focus on people with low levels of academic education and limited English proficiency.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Hepatitis B knowledge and associated factors among people with chronic hepatitis B

Hajarizadeh

Wallace

Richmond

et al. 2015

Australian and New Zealand Journal of Public Health

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“…While Aboriginal and Torres Strait Islanders are estimated to be 9% of the total population of people with CHB living in Australia, only one participant in this study identified as a member of these communities (34). The lack of representation of Aboriginal and Torres Strait Islander people in this study reflects the poor access of these populations to clinical services and highlights a need to develop innovative and culturally appropriate models of care to improve access to CHB clinical management for these populations, and for further research to identify the barriers to clinical services (36, 37). No data about liver disease stage and time of CHB diagnosis were collected in this study and it is probable that having more advanced liver disease and longer duration since CHB diagnosis will affect a patient’s psychological response to hepatitis B.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis B-Related Concerns and Anxieties Among People With Chronic Hepatitis B in Australia

et al. 2016

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BackgroundThe psychological wellbeing of people with chronic hepatitis B (CHB) may be negatively affected due to the chronic and transmissible nature of the disease, and possible serious complications (e.g. cirrhosis and liver cancer). There are limited data investigating concerns and anxieties among people living with CHB.ObjectivesThis study examined feelings about having hepatitis B among people with CHB, including hepatitis B-related concerns and anxieties.Patients and MethodsUsing convenience sampling, people with CHB attending four public liver clinics and one general practice in three Australian jurisdictions between April and September 2013 completed a self-administered questionnaire about their feelings about having hepatitis B.ResultsNinety-three people completed the survey. Mean age was 45 years, 57% were men, and 93% were born overseas (75% from Asia). Seventy-six percent of participants reported having hepatitis B-related concerns and anxieties. The most common concerns were of developing liver cancer (57%), and infecting other people (53%). Thirty-five percent of participants were unwilling to talk to anyone about their hepatitis B while 25% changed how they lived as a result of having hepatitis B. Lower educational level was associated with feeling scared of hepatitis B (adjusted Odds Ratio [OR]: 4.04; 95%CI: 1.09, 14.90; P = 0.04), and an unwillingness to talk to anyone about hepatitis B (adjusted OR: 4.41; 95%CI: 1.09, 17.83; P = 0.04). Very good English proficiency was associated with a higher likelihood of participants changing how they lived (adjusted OR: 12.66; 95%CI: 2.21, 72.42; P < 0.01), and seeing life differently as a result of having hepatitis B (adjusted OR: 21.10; 95%CI: 3.70, 120.19; P < 0.01). Health professionals were the key person for 34% of participants in helping them cope with having hepatitis B, while 18% reported that no one supported them.ConclusionsHepatitis B-related concerns and anxieties are prevalent among people with CHB. Clinical management of people with CHB must address their psychological support needs as an essential component of comprehensive care.

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“…Indeed, to avoid a substantial increase in the burden of advanced liver disease in NSW, primary care providers need to take a more active role in testing those at risk of, and managing people with, chronic hepatitis B. Australian research suggests that primary care providers would be willing to take on an expanded role in the management and treatment of chronic hepatitis B, especially if these providers are confident that they can access specialist advice and support in a timely manner. [20][21][22] This will require a new process to better link general practitioners with specialist support.…”

Section: Support Primary Care To Play a Larger Role In Monitoring Mamentioning

confidence: 99%

Increased use among GPs of hepatitis B vaccine for priority populations

Sheppeard¹

2017

Public Health Res Pract

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03NSW HEALTH HEPATITIS B STRATEGY 2014-2020 Despite being a vaccine preventable disease, hepatitis B is a substantial public health problem in Australia and internationally. It is a major cause of liver disease, including liver cancer, and drives much of the demand for liver transplantation.In NSW, about 77,000 people are living with hepatitis B, many of whom are not aware that they have the infection. Hepatitis B is disproportionately common among people originating from high prevalence countries and Aboriginal people, and this pattern of infection has implications for the public health response to hepatitis B in NSW.In recent years in NSW, we have experienced success in preventing locally acquired hepatitis B infections, and our public health professionals are rightly proud of the reach and effectiveness of established hepatitis B vaccination programs, in particular the universal infant hepatitis B vaccination program. Additionally, over many decades our specialist services have made an enormous contribution to the health of individuals and populations through the provision of high quality clinical care.Nevertheless, more work is required to reduce the impact of hepatitis B in NSW. We need to reduce current levels of hepatitis B transmission, reduce the pool of undiagnosed infections, and do more to ensure that people with chronic hepatitis B are engaging with health services, so that their infection can be regularly monitored and effectively managed.Our priorities for action are clear. We will build on existing strategies to prevent the transmission of hepatitis B in NSW and make it easier for people at risk of hepatitis B to get tested. We will support people who are newly diagnosed into a pathway of care and support general practitioners and other primary health care professionals to play a larger role in monitoring, managing and treating hepatitis B. And, we will help people with chronic infection to effectively manage their condition. Underpinning these actions is a focus on effective coordination of services and programs to ensure continuity of care for patients.We have set five Targets to be achieved by 2020. ACTIONS SYSTEM ENABLERS• Surveillance• Performance monitoring and evaluation• Clinical redesign and innovation• Health systems and policy relevant research• Workforce development• Cultural competence• Community engagement and partnerships • Effective governance• An evidence-informed population health approach PRIORITY POPULATIONS• People living with hepatitis B • STRATEGY 2014STRATEGY -2020 Addressing the burden of chronic hepatitis B in NSW requires a preemptive strategy for the provision of care, focusing in particular on improving diagnosis and management of hepatitis B infections. In NSW, established antenatal screening for hepatitis B provides an opportunity for early detection and intervention in pregnant women and their infants. Diagnosis during pregnancy also provides opportunities to promote testing and vaccination among family and household contacts and to initiate ongoing care to prev...

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Challenges in managing patients in Australia with chronic hepatitis B: the General Practitioners’ perspective

Cited by 25 publications

References 21 publications

Hepatitis B knowledge and associated factors among people with chronic hepatitis B

Hepatitis B knowledge and associated factors among people with chronic hepatitis B

Hepatitis B-Related Concerns and Anxieties Among People With Chronic Hepatitis B in Australia

Increased use among GPs of hepatitis B vaccine for priority populations

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