One size does not fit all: healthcare worker perspectives on hepatitis B models of care in a low-prevalence region in Australia

Abstract

Objective

Australia is not on track to achieve national hepatitis B elimination care targets. Many low hepatitis B prevalence Australian regions have disproportionately lower care uptake rates than higher-prevalence regions. This study aimed to determine enablers to providing care in a low hepatitis B prevalence region of Australia.

Methods

Semi-structured interviews were conducted with healthcare workers in the Barwon South West region of Victoria, Australia, to identify their perspectives on hepatitis B care and service delivery.

Results

Between August and November 2023, 20 participants were interviewed including nine general practitioners, four nurses, three specialists, three interpreters, and one refugee worker. Hepatitis B was understood as a rare, complex condition. The increasing pressure on general practitioners to manage specialist health conditions affected their willingness to manage hepatitis B. Enablers included specialist nurses providing case management and developing systematic links between specialist clinic staff and general practitioners. A localised community of practice would build general practitioner confidence.

Conclusions

Low-prevalence regions have unique hepatitis B care challenges. Disease prevalence needs to be considered when implementing decentralised models of care, with infrequent exposure challenging general practitioner confidence and skill maintenance.

Implications for Public Health

The model for community-based hepatitis B care should be guided by prevalence and regional population characteristics and supported by enabling infrastructure.