The Role of Primary Health Care in Hepatitis B Testing and Management: A Case Study
AuthorRichmond, JA; Sasadeusz, J; Temple-Smith, M
Source TitleJournal of Community Health
Melbourne Medical School
Document TypeJournal Article
CitationsRichmond, J. A., Sasadeusz, J. & Temple-Smith, M. (2018). The Role of Primary Health Care in Hepatitis B Testing and Management: A Case Study. JOURNAL OF COMMUNITY HEALTH, 43 (1), pp.38-47. https://doi.org/10.1007/s10900-017-0385-9.
Access StatusOpen Access
Hepatitis B is a complex disease requiring lifelong management. Infection is linked to birth in high prevalence regions including Africa and Asia. Best practice guidelines identify who to test for hepatitis B, however, a significant proportion of Australians with hepatitis B have not been diagnosed, and are subsequently at risk of serious morbidity and mortality. This study sought to address the gap between current and optimal hepatitis B testing in a primary care clinic with a likely high population of undiagnosed hepatitis B. Between September 2015 and December 2016, four interventions aimed at enhancing general practitioner testing practices were implemented: staff education, quality improvement and patient-triggered activities. Compared to the baseline (2014) the following parameters all increased in 2016: the number of patients tested (15 tests per month in 2014, 24 tests per months in 2016), the correct ordering of the recommended tests (17% in 2014, 61% in 2016) and hepatitis B vaccine dose ordering (n = 35 in 2014, n = 110 in 2016). However, the proportion of patients born in Africa or Asia tested for hepatitis B did not increase. Distribution of a patient held-reminder led to the greatest number of tests being ordered (n = 54 tests ordered in 1 month). Within a single primary care clinic situated in a high hepatitis B prevalence area, an intervention designed to improve adherence to hepatitis B testing guidelines, increased testing levels. A systematic approach can assist general practitioners to improve their understanding of hepatitis B testing and prioritise people most at risk.
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