A shared care program for the management of patients with chronic hepatitis B in a Canadian primary care refugee clinic

IF 3.2 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health Pub Date : 2025-08-01 DOI:10.1016/j.puhe.2025.105894

Rachel Talavlikar , Andrea R. Hull , Jazmin Marlinga , Biniam Soquar , Stephen E. Congly , Samuel S. Lee

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引用次数: 0

Abstract

Objectives

Refugees in Canada are disproportionately affected by chronic hepatitis B (CHB) and its complications due to healthcare barriers and resettlement challenges. In 2011 the Mosaic Refugee Health Clinic (MRHC) in Calgary, Canada began a shared care model for CHB. Family physicians identify and monitor chronically infected patients, reviewing cases with hepatology.

Study design

A cohort of all adult patients (≥18 years old) with a positive hepatitis B surface antigen result (HBsAg) between January 1, 2011 and December 31, 2020 was assessed through retrospective chart review.

Methods

Variables collected included basic demographics and disease characterization, monitoring parameters, and follow-up intervals. These were analyzed using descriptive statistics.

Results

A total of 171 cases were managed during the study time frame, representing 2.6 % of the total number of adult patients (6511) taken into the clinic. Of the cohort, 139 patients (81.0 %) were followed for more than a year. Nearly all patients (98 %) completed a full panel of recommended baseline lab testing, 88 % met ongoing ALT lab surveillance targets, and 70 % ultrasound surveillance. The majority (83 %) were reviewed by the hepatologist within 6 months.

Conclusions

This unique model is the first example of a registry of CHB patients in a longitudinal program at a refugee primary care clinic. The observed high rates of adherence were likely achieved by empowering a primary health care interdisciplinary team with specialty support. No funding was utilized for this study.

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加拿大初级保健难民诊所慢性乙型肝炎患者管理的共享护理方案

由于医疗障碍和重新安置的挑战，加拿大的难民不成比例地受到慢性乙型肝炎（CHB）及其并发症的影响。2011年，加拿大卡尔加里的马赛克难民健康诊所（MRHC）开始了对慢性乙型肝炎的共享护理模式。家庭医生识别和监测慢性感染患者，审查肝病病例。研究设计通过回顾性图表回顾，对2011年1月1日至2020年12月31日期间乙型肝炎表面抗原（HBsAg）阳性的所有成年患者（≥18岁）进行队列评估。方法收集的变量包括基本人口统计学和疾病特征、监测参数和随访时间间隔。使用描述性统计对其进行分析。结果在研究期间共处理了171例病例，占进入诊所的成年患者总数（6511例）的2.6%。在该队列中，139例患者（81.0%）随访超过一年。几乎所有患者（98%）都完成了推荐的全部基线实验室检测，88%达到了ALT实验室监测目标，70%达到了超声监测。大多数患者（83%）在6个月内接受了肝病专家的复查。结论：这个独特的模型是难民初级保健诊所纵向项目中CHB患者登记的第一个例子。观察到的高依从率可能是通过赋予初级卫生保健跨学科团队以专业支持来实现的。本研究未使用任何资金。

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

Public Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.60

自引率

0.00%

发文量

280

审稿时长

37 days

期刊介绍： Public Health is an international, multidisciplinary peer-reviewed journal. It publishes original papers, reviews and short reports on all aspects of the science, philosophy, and practice of public health.