Patient Involvement in Healthcare is Associated With Higher Rates of Surveillance for Hepatocellular Carcinoma
Patient Involvement in Healthcare is Associated With Higher Rates of Surveillance for Hepatocellular Carcinoma
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DOI：
10.1097/mcg.0b013e31820989d3
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发表时间：
2011-09-01
影响因子：
2.9
通讯作者：
Marrero, Jorge A.
中科院分区：
文献类型：
--
作者：
Singal, Amit G.;Volk, Michael L.;Marrero, Jorge A.
背景资料：肝硬化患者建议监测肝细胞癌（HCC），但早期研究表明，它的使用时间不到三分之一。患者因素与监测率不完全understood.Goals：我们的研究的目的是确定肝癌监测率在三级保健中心，并确定患者接受surveillance.Study的预测因素：与儿童A或B肝硬化患者在密歇根大学肝脏诊所看到2008年10月和2009年3月之间被招募完成自我管理的调查。监测率和临床数据从病人的电子病历中提取。结果：在160例患者入组，74.4%的肝癌监测在过去的一年中进行。在多变量分析中，接受监测的预测因素包括男性（比值比7.1，95%置信区间，1.2-43.2）和患者参与护理（比值比3.4，95%置信区间，1.5-7.9）。患者表达了高度的关注肝癌，希望更多的信息，从他们的医生，并希望更多地参与他们的care.Conclusions：肝癌监测率在三级医疗中心显着高于早期报道的利率。患者直接参与HCC监测的决策可能有助于提高监测率。
Background: Surveillance for hepatocellular carcinoma (HCC) is recommended in patients with cirrhosis, but earlier studies suggest that it is used less than one-third of the time. Patient factors associated with surveillance rates are incompletely understood.Goals: The aims of our study were to determine HCC surveillance rates in a tertiary-care center and to identify patient predictors of receiving surveillance.Study: Patients with Child A or B cirrhosis seen in the University of Michigan liver clinics between October 2008 and March 2009 were enrolled to complete a self-administered survey. Surveillance rates and clinical data were extracted from the patient electronic medical record.Results: Of the 160 patients enrolled, 74.4% had HCC surveillance performed in the past year. On multivariate analysis, predictors of receiving surveillance included male sex (odds ratio 7.1, 95% confidence interval, 1.2-43.2) and patient involvement in their care (odds ratio 3.4, 95% confidence interval, 1.5-7.9). Patients expressed high levels of concern regarding HCC, desired more information from their physicians, and wanted to be more involved in their care.Conclusions: HCC surveillance rates in a tertiary-care center were significantly higher than earlier reported rates. Direct patient involvement in decisions regarding HCC surveillance may help to improve surveillance rates.