Formal hepatitis C education enhances HCV care coordination, expedites HCV treatment and improves antiviral response.
Formal hepatitis C education enhances HCV care coordination, expedites HCV treatment and improves antiviral response.
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DOI：
10.1111/liv.12150
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发表时间：
2013-08
期刊：
影响因子：
--
通讯作者：
Khalili M
中科院分区：
文献类型：
--
作者：
Lubega S;Agbim U;Surjadi M;Mahoney M;Khalili M
正规的HCV教育提高了HCV知识，但对治疗吸收和结果的影响还没有得到很好的描述。我们的目的是评估正式的HCV患者教育对初级提供者-专科医生HCV感染和治疗的影响。对旧金山弗朗西斯科安全网医疗保健系统内的初级保健提供者进行了调查，并回顾性审查了肝脏专业开设正式HCV教育课程之前和之后（2006-2011年）的HCV感染患者的记录。118例接受抗-HCV治疗的患者的特征为：平均年龄51岁，73%为男性，约50%为白色和无保险者。接受过正规教育的患者开始HCV治疗的时间较短（中位数136 vs. 284天，p<0.0001）。当控制年龄、性别、种族和HCV病毒载量时，非1基因型（OR 6.17，95%CI 2.3-12.7，p=0.0003）和接受HCV教育（OR 3.0，95%CI 1.1-7.9，p=0.03）与持续的病毒学治疗应答相关。在94名供应商受访者（回复率=38%）中，平均年龄为42岁，62%为白色，63%为女性。大多数提供者认为HCV教育课程增加了患者的HCV知识（70%），对HCV治疗的兴趣（52%）和提供者与患者的沟通（56%）。积极的提供者态度（Coef 1.5，95%CI 0.1- 2.9%，p=0.039）与教育类的转诊率独立相关。正规的HCV教育可加快HCV治疗并提高病毒学应答率。由于初级保健提供者的态度在转诊到HCV教育班中起着重要作用，提高提供者的知识可能会提高弱势人群获得HCV专科服务的机会。
Formal HCV education improves HCV knowledge but the impact on treatment uptake and outcome is not well described. We aimed to evaluate the impact of formal HCV patient education on primary provider-specialist HCV comanagement and treatment. Primary care providers within the San Francisco safety-net health care system were surveyed and the records of HCV-infected patients before and after institution of a formal HCV education class by liver specialty (2006–2011) were reviewed retrospectively. Characteristics of 118 patients who received anti-HCV therapy were: mean age 51, 73% males, and ~50% White and uninsured. The time to initiation of HCV treatment was shorter among those who received formal education (median 136 vs. 284 days, p<0.0001). When controlling for age, gender, race, and HCV viral load, non-1 genotype (OR 6.17, 95%CI 2.3–12.7, p=0.0003) and receipt of HCV education (OR 3.0, 95%CI 1.1–7.9, p=0.03) were associated with sustained virologic treatment response. Among 94 provider respondents (response rate=38%), mean age was 42, 62% were White, and 63% female. Most providers agreed that the HCV education class increased patients’ HCV knowledge (70%), interest in HCV treatment (52%), and provider-patient communication (56%). A positive provider attitude (Coef 1.5, 95%CI 0.1–2.9 percent, p=0.039) was independently associated with referral rate to education class. Formal HCV education expedites HCV therapy and improves virologic response rates. As primary care provider attitude play a significant role in referral to HCV education class, improving provider knowledge will likely enhance access to HCV specialty services in the vulnerable population.
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DOI：
10.1111/j.1478-3231.2011.02706.x
发表时间：
2012-02
期刊：
Liver international : official journal of the International Association for the Study of the Liver
影响因子：
--
作者：
McGowan CE;Fried MW
通讯作者：
Fried MW
影响因子：
3.1
作者：
Surjadi, Miranda;Torruellas, Cara;Khalili, Mandana
通讯作者：
Khalili, Mandana
影响因子：
5.9
作者：
Fraenkel, L;McGraw, S;Garcia-Tsao, G
通讯作者：
Garcia-Tsao, G
影响因子：
4.2
作者：
Stoové, MA;Gifford, SM;Dore, GJ
通讯作者：
Dore, GJ
影响因子：
0.8
作者：
Rodis, Jennifer L.;Kibbe, Pamella
通讯作者：
Kibbe, Pamella