Reducing patient and provider knowledge gaps: An evaluation of a community informed hepatitis C online course

Buller-Taylor, Terri; McGuinness, Liza; Yan, Melissa; Janjua, Naveed Z.

doi:10.1016/j.pec.2018.01.008

Cited by 17 publications

(21 citation statements)

References 20 publications

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“…In countries where antenatal HBV prevalence is high, they represent a population sub-group to be targeted for HBV micro-elimination. If pregnant women have accurate information on HBV transmission and prevention through vaccination, they are more likely to engage with the health care system, to actively seek and get testing services and ensure their unborn babies are protected, as studies in similar infectious diseases have shown [19,20]. Yet there is limited documentation of the extent of awareness and specific knowledge about HBV, its transmission or prevention, among pregnant women.…”

Section: Introductionmentioning

confidence: 99%

Correlates of hepatitis B awareness and disease-specific knowledge among pregnant women in Northern and Central Uganda: a cross-sectional study

Nankya-Mutyoba

Aizire

Makumbi

et al. 2018

Hepatology Medicine Policy

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IntroductionCountries in sub-Saharan Africa with a high hepatitis B burden also have limited resources to identify underlying drivers of disease among key at-risk populations. To improve prioritization and strengthen prevention of mother to child transmission of HBV, it is imperative to understand disease awareness, knowledge and related factors among pregnant women.ObjectivesThis study assessed HBV disease awareness, knowledge and related factors among pregnant women in public health facilities in two regions with diverse HBV disease epidemiology.MethodsFrom October 2016 through December 2017, a random sample of 455 pregnant women attending antenatal clinics were surveyed to assess HBV awareness, knowledge and associated factors. Participants responded to an 18-item questionnaire with themes on HBV awareness, knowledge of disease signs and symptoms, transmission, prevention and misconceptions about the disease. Results were analysed in STATA (version 14.0).ResultsOf 455 participants enrolled, about two thirds reported having heard about HBV disease. By region, nearly half (47%) of participants from the central region, compared to only 16% from the north, reported that they had never heard of HBV. Region of residence had a moderating effect on the education- HBV awareness relationship. Only 162/455 (36%) of participants had adequate HBV knowledge. More than half 256/455 (56%) and 242/455 (53%) were not knowledgeable about horizontal and mother to child HBV transmission, respectively. About two thirds 298/455 (66%) and 281/455 (62%) believed HBV was spread via sharing of utensils and mosquito bites respectively. In multiple regression analysis, residing in the north, (PR=1.91(1.53 -2.38), p < 0.001) compared to central region and having a secondary education (PR=1.87(1.37 -2.55), p < 0.001) compared to primary were statistically significantly related to being knowledgeable about HBV.ConclusionWe demonstrated marked regional differences in HBV disease awareness and knowledge in this high HBV prevalence setting. However, most pregnant women displayed unacceptably low HBV knowledge and a significant proportion still hold misconceptions about HBV. Interventions to improve HBV prevention through antenatal education will need to be tailored to existing differences in comprehensive HBV knowledge.

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Section: Introductionmentioning

confidence: 99%

Correlates of hepatitis B awareness and disease-specific knowledge among pregnant women in Northern and Central Uganda: a cross-sectional study

Nankya-Mutyoba

Aizire

Makumbi

et al. 2018

Hepatology Medicine Policy

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“…Second, training healthcare workers on HCV infection risk factors and prevention is equally important. 35 Focused training of healthcare workers plays a crucial role to the reduction in healthcare-associated HCV infection in the population through breaking the chain of transmission and help reduce work-related risk of acquiring HCV among healthcare workers themselves.…”

Section: Resultsmentioning

confidence: 99%

A Path to Ending Hepatitis C in Ethiopia: A Phased Public Health Approach to Achieve Micro-Elimination

Taye

2019

The American Journal of Tropical Medicine and Hygiene

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Ethiopia's hepatitis C virus (HCV) prevalence is predicted to rise by 2030. To halt this increasing trend, a suitable approach to the elimination of HCV is needed. This review explores the current status, challenges, and opportunities and outlines a strategy for the micro-elimination approach in Ethiopia. I searched PubMed and EMBASE using combined Medical Subject Heading databases for the literature on HCV micro-elimination. A phased public health approach to HCV micro-elimination, including preparation/capacity building (phase I), implementation (phase II), and rollout and scale-up (phase III), targeting people living with HIV, prisoners, chronic hepatitis and cancer patients, blood donors, and pregnant women is a pragmatic strategy to Ethiopia. This can be implemented at general and tertiary care referral hospitals with a future scale-up to district hospitals through task-shifting by training general practitioners, nurses, laboratory technologists, and pharmacists. Availability of the highly effective direct-acting antivirals (DAAs) can be ensured by expanding the existing program that provides highly subsidized DAAs through an agreement with Gilead Sciences, Inc. and eventually aiming at domestic generic manufacturing. The significant enablers to HCV microelimination in Ethiopia include the control of healthcare-associated HCV infection, blood safety, access to affordable testing and pan-genotypic DAAs, task-shifting, multisectoral partnership, and regulatory support. General populationbased HCV screening and treatment are not cost-effective for Ethiopia because of high cost, program complexity, and disease epidemiology.

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“…Targeting education toward interprofessional HCV care teams may also represent a potential provider‐level facilitator to enhancing post‐SVR monitoring and HCC screening. In a recent study, a 1‐hour online HCV course provided education to a multidisciplinary team of health and social care workers, educators, and volunteers and enhanced their knowledge and ability to engage their clients in HCV care . Such interventions along with provider education and the addition of post‐SVR follow‐up and HCC screening as clinic quality improvement measures in those with advanced liver disease will provide multilevel opportunities to improve adherence to post‐SVR best practices.…”

Section: Discussionmentioning

confidence: 99%

“…In a recent study, a 1-hour online HCV course provided education to a multidisciplinary team of health and social care workers, educators, and volunteers and enhanced their knowledge and ability to engage their clients in HCV care. (31) Such interventions along with provider education and the addition of post-SVR follow-up and HCC screening as clinic quality improvement measures in those with advanced liver disease will provide multilevel opportunities to improve adherence to post-SVR best practices. Finally, the integration of multiple strategies across systems, such as a comprehensive public health approach involving reimbursement, clinical guidelines, training, and prevention education, which has already been shown to enhance access to HCV care among injection drug users, may also represent system-level opportunities to enhance post-SVR care in the larger underserved population.…”

Section: Discussionmentioning

confidence: 99%

Liver Disease Monitoring Practices After Hepatitis C Cure in the Underserved Population

Kim

Magee

Cummings

et al. 2018

Hepatology Communications

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Recent hepatitis C virus (HCV) guidelines recommend disease monitoring and hepatocellular carcinoma (HCC) screening in patients with advanced fibrosis after a sustained virologic response (SVR) with direct‐acting antiviral (DAA) therapy. However, data on practice patterns in this setting is lacking. We aimed to characterize disease monitoring and HCC screening practices post‐SVR in an underserved HCV‐infected cohort. Records of 192 patients who received DAA therapy at the San Francisco safety‐net health care system between January 2014 and January 2016 with ≥12 months of follow‐up post‐SVR were reviewed. Patient characteristics were median age 58 years, 61.5% men, 39.1% White (23.4% Black, 16.7% Latino, 16.2% Asian), 78.1% English proficient, 48.9% intravenous drug use, 53.2% alcohol use, and 41% advanced (F3 and F4) fibrosis (26.6% with decompensation, 11.4% with HCC). Median post‐SVR follow‐up time was 22 months. A higher proportion of patients with advanced fibrosis attended liver clinic visits (mean, 1.94 ± 2.03 versus 1.12 ± 1.09 visits; P = 0.014) and had liver imaging (41.4% versus 9.73%; P < 0.001) post‐SVR, but there was no difference in alanine aminotransferase (ALT) testing (72.2% versus 66.4%; P = 0.40) compared to those without advanced fibrosis. However, 20% with advanced fibrosis had no HCC screening while 35% with no advanced fibrosis had liver imaging. Three patients with cirrhosis developed new HCC. Conclusion: Although the majority of patients with advanced fibrosis in this underserved cohort received post‐SVR monitoring, gaps in HCC screening were identified and new cases of HCC occurred during a short follow‐up. This highlights the importance of incorporating recently enhanced guidelines to optimize post‐SVR monitoring, especially in difficult to engage populations.

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Reducing patient and provider knowledge gaps: An evaluation of a community informed hepatitis C online course

Cited by 17 publications

References 20 publications

Correlates of hepatitis B awareness and disease-specific knowledge among pregnant women in Northern and Central Uganda: a cross-sectional study

Correlates of hepatitis B awareness and disease-specific knowledge among pregnant women in Northern and Central Uganda: a cross-sectional study

A Path to Ending Hepatitis C in Ethiopia: A Phased Public Health Approach to Achieve Micro-Elimination

Liver Disease Monitoring Practices After Hepatitis C Cure in the Underserved Population

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