scholarly journals Peer-to-Peer Sessions in Primary Care to Improve the Hepatitis B Detection Rate in Seville, Spain

2018 ◽  
Vol 17 (5) ◽  
pp. 864-870
Author(s):  
María Ángeles Otero ◽  
Chang-Hai Liu ◽  
Javier Ampuero ◽  
Rocío Llorca ◽  
Manuel Vargas ◽  
...  
Keyword(s):  
Primary Care ◽  
Hepatitis B ◽  
Detection Rate ◽  
Peer To Peer

P673 DETECTION AND DERIVATION RATE AFTER PEER-TO-PEER TRAINING SESSIONS IN PRIMARY CARE ON THE SCREENING OF HEPATITIS B

2014 ◽  
Vol 60 (1) ◽  
pp. S293
Author(s):  
M.Á. Otero-Fernández ◽  
R. Llorca ◽  
J. Ampuero ◽  
A. Martinez-Alcala ◽  
M. Vargas-Perez ◽  
...  
Keyword(s):  
Primary Care ◽  
Hepatitis B ◽  
Peer To Peer ◽  
Peer Training

Diagnostic accuracy of transient elastography (FibroScan) versus the aspartate transaminase to platelet ratio index in assessing liver fibrosis in chronic hepatitis B: The role in primary care setting

2011 ◽  
Vol 64 (10) ◽  
pp. 916-920 ◽  
Author(s):  
C Rinaldi A Lesmana ◽  
Simon Salim ◽  
Irsan Hasan ◽  
Andri S Sulaiman ◽  
Rino A Gani ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Diagnostic Accuracy ◽  
Chronic Hepatitis B ◽  
Care Setting ◽  
Primary Care Setting ◽  
Transient Elastography ◽  
Liver Stiffness

BackgroundA non-invasive method to assess liver fibrosis by measuring liver stiffness with transient elastography (TE) has been recently introduced. The role of TE among chronic hepatitis B (CHB) patients in starting antiviral therapy in the primary care setting is still controversial because of its high cost. The AST to platelet ratio index (APRI) could be a much cheaper alternative.ObjectivesThis study compares the diagnostic accuracy of TE and APRI in assessing liver fibrosis in CHB patients.Patients and MethodsA cross-sectional study in CHB patients intending to start antiviral treatment. Liver fibrosis was staged according to the METAVIR scoring system. Liver stiffness was measured by TE performed on the same day with liver biopsy, while APRI was calculated as follows: APRI=(AST/upper limit of normal)×100/platelet count (109/l). Cutoff levels of liver stiffness and APRI were calculated by using the receiver operating characteristic curve to detect significant liver fibrosis, defined as fibrosis stage F2 or more.Results117 patients were enrolled in the study; their mean age was 40.6±10.97 years. The median liver stiffness was 5.9 kPa (2.5–48 kPa) and the median APRI was 0.239 (0.09–2.73). The cutoff level of liver stiffness was 5.85 kPa for ≥F2 with an AUC of 0.614, 60.3% sensitivity, 63.6% specificity, 73.3% PPV, 49.1% NPV and a LR+ of 1.66. The APRI cutoff level was 0.235 for F≥2 with an AUC of 0.693, 64.4% sensitivity, 70.5% specificity, 78.3% PPV, 54.4% NPV and a LR+ of 2.18. Both methods gave comparable diagnostic accuracy.ConclusionAPRI is a useful marker to screen liver fibrosis in the primary care setting when TE is not available.

scholarly journals Hepatitis B Vaccination and Screening Awareness in Primary Care Practitioners

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Adnan Said ◽  
Janice H. Jou
Keyword(s):  
Primary Care ◽  
Hepatitis B ◽  
Sexual Transmission ◽  
Risk Groups ◽  
Healthy People ◽  
Hepatitis B Vaccination ◽  
Attitudes And Practices ◽  
Barriers To Screening ◽  
History Of ◽  
Primary Care Practitioners

Introduction. The goals of Healthy People US 2020 have called for increased screening and vaccination of high-risk groups for Hepatitis B (HBV). Methods. We performed a survey of 400 randomly chosen primary care practitioners (PCPs) in Wisconsin to assess their knowledge, attitudes, and practices regarding screening and vaccination for HBV. Results. Screening rates of patients at risk of sexual transmission were low, with 61% of respondents stating that they screen patients who had more than 1 sex partner in 6 months and 86% screening patients with a history of sex with prostitutes. Screening rate for persons with a history of intravenous drug use was 94%. Children of immigrants were screened by 65%, persons on hemodialysis by 73%, and prison inmates by 69%. Screening increased with provider experience with HBV. Deficiencies in vaccination rates mirrored screening practices. Major barriers to screening were cost, someone else’s responsibility, time constraints, or lack of knowledge. Conclusions. Without improved education and practices of PCPs about HBV screening and vaccination, the goals of healthy people 2020 regarding HBV will not be met. Barriers to screening and vaccination need to be addressed. Cost-effectiveness of alternative strategies such as universal vaccination under the age of 50 should be explored.

scholarly journals Assessing testing rates for viral hepatitis B and C by general practitioners in Flanders, Belgium: a registry-based study

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e026464 ◽  
Author(s):  
Rob Bielen ◽  
Özgür M Koc ◽  
Dana Busschots ◽  
Geert Robaeys ◽  
Bert Aertgeerts ◽  
...  
Keyword(s):  
Primary Care ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Viral Hepatitis ◽  
Real Life ◽  
Life Testing ◽  
Viral Hepatitis B ◽  
Testing Uptake ◽  
Care Practices ◽  
Primary Care Practices

ObjectivesChronic infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) have a major impact on mortality worldwide. Although effective treatments are available for both HBV and HCV infection, <50% of the patients are even diagnosed in Belgium. This study assessed the real-life testing—and diagnosis rate by general practitioners (GPs) in Flanders, Belgium.SettingWe assessed the testing rate for HBV and HCV in 48 primary care practices with electronic medical records linked into one central registry in Flanders, Belgium.ParticipantsThe registry contains data of 440 140 patients over 20 years, which corresponds to 2.2% of the total Flemish population yearly. The primary care practices are distributed across Flanders and the patient population is representative for the distribution of age, gender and socioeconomic status at the community level.ResultsOf 440 140 patients included in the registry, 7892 (1.8%) patients were screened for hepatitis B surface antigen (HBsAg) and 7206 (1.6%) for hepatitis C antibody (HCV Ab) of whom 369 (4.7%) and 163 (2.3%) tested positive, respectively. Of 14 059 patients with chronic liver enzyme elevation, 1112 (7.9%) and 1395 (9.9%) were tested for HBsAg and HCV Ab, respectively. There was no improvement in testing rates over time.ConclusionsThis study demonstrates that real-life testing uptake for viral hepatitis B and C is suboptimal in the general practices in Flanders, even in patients with chronically elevated liver enzymes. As GPs play a crucial role in prevention, diagnosis and linkage to care, efforts and strategies to increase the testing uptake for HBV and HCV are urgently needed.

Physicians' Detection of Psychological Distress in Primary-Care Clinics

1991 ◽  
Vol 69 (3) ◽  
pp. 999-1003 ◽  
Author(s):  
Benyamin Maoz ◽  
Stanley Rabinowitz ◽  
Mordechai Mark ◽  
Helen Antonovsky ◽  
Joseph Ribak ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Psychological Distress ◽  
Health Education ◽  
Medical Care ◽  
Emotional Distress ◽  
Detection Rate ◽  
Psychiatric Training ◽  
Primary Care Clinics ◽  
Military Physicians

This study investigated the amount of psychological distress reported by 182 soldiers in the Israeli military and compared soldiers' self-ratings of distress with ratings by military physicians of observed distress. Comparisons indicated a low detection rate by physicians with only 13% of self-reported cases of emotional distress identified. This and several related findings were taken to indicate shortcomings in medical care. Possible remedies include additional psychiatric training for military physicians, less frequent rotation of physicians to allow for more stable care, and the initiation of mental health education among soldiers.

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