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Factors affecting adherence to HBV guidelines

04 Aug 2017
WHO urges global attention over increasing hepatitis mortality rates.

Regardless of practice setting, the rates of adherence to hepatitis B virus (HBV) guidelines are unsatisfactory and influenced by several provider, patient and practice factors, reports a study.

To assess provider knowledge, attitudes and barriers to HBV care and management practices, researchers surveyed providers across various healthcare settings in San Francisco, USA. They used multivariate analyses to identify factors related to recommended HBV screening, vaccination and disease monitoring.

A total of 277 providers responded to the survey. Of these, 42 percent reported performing HBV screening in >50 percent of at-risk patients and 49 percent reported performing HBV vaccination in >50 percent of eligible patients.

Most providers reported appropriate monitoring of a majority of HBV-infected patients with alanine aminotransferase (79 percent) and HBV viral load (67 percent) every 6 to 12 months. However, hepatocellular carcinoma screening was performed only in 49 percent.

HBV screening was significantly associated with the following provider factors: speaking an Asian language (odds ratio [OR], 3.27), offering HBV treatment (OR, 3.00), having >25 percent of Asian patients in practice (OR, 2.10), practicing in safety net settings (OR, 7.51) and having higher barrier score (OR, 0.74). In addition, provider factors associated with appropriate HBV monitoring were speaking an Asian language (OR, 3.43) and age (OR, 0.68/decade).

Hepatocellular carcinoma screening correlated with having >25 percent of patients speaking English as a second language (OR, 4.26) and practicing in safety net settings (OR, 0.14).

“This study reinforces the importance of engaging primary care providers in development, dissemination and implementation of evidence-based HBV practice guidelines,” researchers said.

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Most Read Articles
3 days ago
Prenatal and postpartum vitamin D supplementation does not appear to improve foetal or infant growth, a study reports.
5 days ago
Excessive daytime sleepiness appears to increase the long-term risk of amyloid β (Aβ) deposition, a recent study has shown.
5 days ago
Substituting diets high in carbohydrates with those high in monounsaturated fatty acids in the context of low saturated fatty acids do not appear to yield favourable effects on blood pressure, according to a meta-analysis.
6 days ago
Among obese and overweight adults with type 2 diabetes mellitus, women appear to be less likely than men to develop mild cognitive impairment, independent of traditional risk factors, a recent study has shown.