Clinical audit of quality of care among patients with viral hepatitis in primary care in a low endemic region.

IF 2.4 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Family practice Pub Date : 2024-10-08 DOI:10.1093/fampra/cmae019

Özgür M Koc, Bert Vaes, Geert Robaeys, Cristian F Catalan, Bert Aertgeerts, Frederik Nevens

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引用次数: 0

Abstract

Background: The current hepatitis B (HBV) and hepatitis C virus (HCV) screening practices may fail to detect many infected patients who could benefit from new therapeutic agents to limit progression to cirrhosis and hepatocellular carcinoma.

Objectives: This study assessed the test positivity rate and cascade of care of viral hepatitis patients in primary care in a low endemic region as well as the testing policy of abnormal alanine aminotransferase (ALT) level.

Methods: This is a retrospective clinical audit among primary health care practices in Flanders, Belgium, assessing patients with an active medical file between 2019 and 2021.

Results: A total of 84/89 (94.4%) primary health care practices participated representing 621,573 patients of which 1069 patients (0.17%) were registered as having viral hepatitis, not further specified. Detailed information was available from 38 practices representing 243,723/621,573 (39.2%) patients of which 169 (0.07%) were HBsAg positive and 99 (0.04%) anti-HCV positive. A total of 96/134(71.6%) chronic HBV-infected and 31/77(40.3%) chronic HCV-infected patients were referred to a hepatologist. A total of 30,573/621,573(4.9%) patients had an abnormal ALT level, and by at random selection, more detailed information was obtained on 211 patients. Information on high-risk groups was missing in up to 60%. In patients with abnormal ALT level, HBsAg and anti-HCV testing were conducted in 37/211(17.5%) and 25/211(11.8%), respectively.

Conclusion: In a low endemic region, the testing rate and cascade of care of HBV and HCV-infected patients can be improved in primary care, especially in high-risk groups and patients with abnormal ALT levels.

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对低流行地区初级保健中病毒性肝炎患者的护理质量进行临床审计。

背景：目前的乙型肝炎（HBV）和丙型肝炎病毒（HCV）筛查方法可能无法检测出许多感染者，而这些感染者本可以从新的治疗药物中获益，从而阻止病情恶化为肝硬化和肝细胞癌：本研究评估了低流行地区初级医疗中病毒性肝炎患者的检测阳性率和护理流程，以及丙氨酸氨基转移酶（ALT）水平异常的检测政策：这是一项对比利时法兰德斯地区初级医疗机构进行的回顾性临床审计，对2019年至2021年期间有有效医疗档案的患者进行评估：共有84/89家（94.4%）初级医疗机构参与，代表了621,573名患者，其中1069名患者（0.17%）登记为病毒性肝炎患者，未作进一步说明。有 38 家医疗机构（代表 243723/621573 例（39.2%）患者）提供了详细信息，其中有 169 例（0.07%）HBsAg 阳性，99 例（0.04%）抗-HCV 阳性。共有 96/134 名（71.6%）慢性 HBV 感染者和 31/77 名（40.3%）慢性 HCV 感染者转诊至肝病专科医生。共有30,573/621,573（4.9%）名患者的谷丙转氨酶（ALT）水平出现异常，通过随机抽取，获得了211名患者的详细信息。高危人群的信息缺失率高达 60%。在ALT水平异常的患者中，分别有37/211（17.5%）和25/211（11.8%）进行了HBsAg和抗-HCV检测：结论：在一个低流行地区，基层医疗机构可以提高 HBV 和 HCV 感染者的检测率和护理流程，尤其是在高危人群和 ALT 水平异常的患者中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Family practice 医学-医学：内科

CiteScore

4.30

自引率

9.10%

发文量

144

审稿时长

4-8 weeks

期刊介绍： Family Practice is an international journal aimed at practitioners, teachers, and researchers in the fields of family medicine, general practice, and primary care in both developed and developing countries. Family Practice offers its readership an international view of the problems and preoccupations in the field, while providing a medium of instruction and exploration. The journal''s range and content covers such areas as health care delivery, epidemiology, public health, and clinical case studies. The journal aims to be interdisciplinary and contributions from other disciplines of medicine and social science are always welcomed.