A care coordination program to support patients with hepatitis B virus at Kaiser Permanente Mid-Atlantic States.

Care coordination Hepatitis B Hepatocellular carcinoma surveillance Linkage-to-care

Journal

BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677

Informations de publication

Date de publication:
18 Apr 2024
Historique:
received: 08 09 2023
accepted: 26 03 2024
medline: 19 4 2024
pubmed: 19 4 2024
entrez: 18 4 2024
Statut: epublish

Résumé

Eliminating hepatitis B virus (HBV) is a significant worldwide challenge requiring innovative approaches for vaccination, screening, disease management, and the prevention of related conditions. Programs that support patients in accessing needed clinical services can help optimize access to preventive services and treatment resources for hepatitis B. Here, we outline a coordinator-supported program (HBV Pathway) that connects patients infected with HBV to laboratory testing, imaging, and specialty care for treatment initiation and/or liver cancer surveillance (screening of high-risk patients for liver cancer). This study describes the HBV Pathway steps and reports sociodemographic factors of patients by initiation and completion. Results showed a 72.5% completion rate (defined as completing all Pathway steps including the final specialty visit) among patients who initiated the Pathway. Differences in completion were observed by age, race, ethnicity, and service area, with higher rates for younger ages, Asian race, non-Hispanic ethnicity, and lower rates for patients within one service area. Of those who completed the specialty visit, 59.5% were referred for hepatocellular carcinoma surveillance. The HBV Pathway offers dual benefits- care coordination support for patients to promote Pathway completion and a standardized testing and referral program to reduce physician burden. This program provides an easy and reliable process for patients and physicians to obtain updated clinical information and initiate treatment and/or liver cancer screening if needed.

Sections du résumé

BACKGROUND BACKGROUND
Eliminating hepatitis B virus (HBV) is a significant worldwide challenge requiring innovative approaches for vaccination, screening, disease management, and the prevention of related conditions. Programs that support patients in accessing needed clinical services can help optimize access to preventive services and treatment resources for hepatitis B.
METHODS METHODS
Here, we outline a coordinator-supported program (HBV Pathway) that connects patients infected with HBV to laboratory testing, imaging, and specialty care for treatment initiation and/or liver cancer surveillance (screening of high-risk patients for liver cancer). This study describes the HBV Pathway steps and reports sociodemographic factors of patients by initiation and completion.
RESULTS RESULTS
Results showed a 72.5% completion rate (defined as completing all Pathway steps including the final specialty visit) among patients who initiated the Pathway. Differences in completion were observed by age, race, ethnicity, and service area, with higher rates for younger ages, Asian race, non-Hispanic ethnicity, and lower rates for patients within one service area. Of those who completed the specialty visit, 59.5% were referred for hepatocellular carcinoma surveillance.
CONCLUSIONS CONCLUSIONS
The HBV Pathway offers dual benefits- care coordination support for patients to promote Pathway completion and a standardized testing and referral program to reduce physician burden. This program provides an easy and reliable process for patients and physicians to obtain updated clinical information and initiate treatment and/or liver cancer screening if needed.

Identifiants

pubmed: 38637807
doi: 10.1186/s12913-024-10907-2
pii: 10.1186/s12913-024-10907-2
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

482

Informations de copyright

© 2024. The Author(s).

Références

JAMA Netw Open. 2023 Apr 3;6(4):e237000
pubmed: 37036709
Clin Gastroenterol Hepatol. 2019 Apr;17(5):976-987.e4
pubmed: 30616961
Clin Gastroenterol Hepatol. 2021 Mar;19(3):607-609.e2
pubmed: 31927112
Am J Manag Care. 2020 Aug;26(8):331-338
pubmed: 32835460
JAMA Netw Open. 2022 Jul 1;5(7):e2223504
pubmed: 35867057
AIDS Patient Care STDS. 2015 Nov;29(11):582-90
pubmed: 26505968
Gastroenterol Hepatol (N Y). 2014 Mar;10(3):153-61
pubmed: 24829542
MMWR Morb Mortal Wkly Rep. 2018 May 18;67(19):541-546
pubmed: 29771873
Hepatology. 2021 Feb;73(2):713-725
pubmed: 32383272
CA Cancer J Clin. 2018 Nov;68(6):394-424
pubmed: 30207593
Int J Integr Care. 2021 Mar 19;21(1):16
pubmed: 33776605
Liver Int. 2018 Feb;38 Suppl 1:122-125
pubmed: 29427490
Clin Infect Dis. 2016 May 15;62(10):1290-1296
pubmed: 26908812
JAMA. 2020 Dec 15;324(23):2415-2422
pubmed: 33320230
PLoS One. 2017 Jun 2;12(6):e0178671
pubmed: 28575040
Open Forum Infect Dis. 2017 May 27;4(3):ofx109
pubmed: 28752101
Liver Int. 2020 Apr;40(4):947-955
pubmed: 31943689
J Hepatocell Carcinoma. 2021 May 20;8:435-450
pubmed: 34046368
World J Gastroenterol. 2021 Jul 14;27(26):4004-4017
pubmed: 34326610
Hepatol Commun. 2018 Nov 15;3(1):8-19
pubmed: 30619990
PLoS One. 2018 Feb 20;13(2):e0191980
pubmed: 29462179
AIDS Patient Care STDS. 2017 May;31(5):222-226
pubmed: 28488904
Lancet Reg Health Am. 2021 Nov 20;7:100120
pubmed: 36777660
MMWR Recomm Rep. 2023 Nov 03;72(4):1-21
pubmed: 37906518

Auteurs

M Cabell Jonas (MC)

Mid-Atlantic Permanente Research Institute, Mid-Atlantic Permanente Medical Group, Rockville, MD, USA. cabell.jonas@kp.org.

Yi-Shin Sheu (YS)

Mid-Atlantic Permanente Research Institute, Mid-Atlantic Permanente Medical Group, Rockville, MD, USA.

Kara Wright (K)

Mid-Atlantic Permanente Research Institute, Mid-Atlantic Permanente Medical Group, Rockville, MD, USA.

Lauren Peyton (L)

Mid-Atlantic Permanente Research Institute, Mid-Atlantic Permanente Medical Group, Rockville, MD, USA.

R Clayton Bishop (RC)

Mid-Atlantic Permanente Research Institute, Mid-Atlantic Permanente Medical Group, Rockville, MD, USA.

Sundeep Basra (S)

Mid-Atlantic Permanente Research Institute, Mid-Atlantic Permanente Medical Group, Rockville, MD, USA.

Fariha Sarwar (F)

Mid-Atlantic Permanente Research Institute, Mid-Atlantic Permanente Medical Group, Rockville, MD, USA.

Grace Winn (G)

Mid-Atlantic Permanente Research Institute, Mid-Atlantic Permanente Medical Group, Rockville, MD, USA.

Karen Chesbrough (K)

Mid-Atlantic Permanente Research Institute, Mid-Atlantic Permanente Medical Group, Rockville, MD, USA.

Classifications MeSH