Public health · 2025
A shared care program for the management of patients with chronic hepatitis B in a Canadian primary care refugee clinic.
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Talavlikar Rachel, Hull Andrea R, Marlinga Jazmin, Soquar Biniam, Congly Stephen E, Lee Samuel S
Аннотация
OBJECTIVES: Refugees in Canada are disproportionately affected by chronic hepatitis B (CHB) and its complications due to healthcare barriers and resettlement challenges. In 2011 the Mosaic Refugee Health Clinic (MRHC) in Calgary, Canada began a shared care model for CHB. Family physicians identify and monitor chronically infected patients, reviewing cases with hepatology.
STUDY DESIGN: A cohort of all adult patients (≥18 years old) with a positive hepatitis B surface antigen result (HBsAg) between January 1, 2011 and December 31, 2020 was assessed through retrospective chart review.
METHODS: Variables collected included basic demographics and disease characterization, monitoring parameters, and follow-up intervals. These were analyzed using descriptive statistics.
RESULTS: A total of 171 cases were managed during the study time frame, representing 2.6 % of the total number of adult patients (6511) taken into the clinic. Of the cohort, 139 patients (81.0 %) were followed for more than a year. Nearly all patients (98 %) completed a full panel of recommended baseline lab testing, 88 % met ongoing ALT lab surveillance targets, and 70 % ultrasound surveillance. The majority (83 %) were reviewed by the hepatologist within 6 months.
CONCLUSIONS: This unique model is the first example of a registry of CHB patients in a longitudinal program at a refugee primary care clinic. The observed high rates of adherence were likely achieved by empowering a primary health care interdisciplinary team with specialty support. No funding was utilized for this study.
STUDY DESIGN: A cohort of all adult patients (≥18 years old) with a positive hepatitis B surface antigen result (HBsAg) between January 1, 2011 and December 31, 2020 was assessed through retrospective chart review.
METHODS: Variables collected included basic demographics and disease characterization, monitoring parameters, and follow-up intervals. These were analyzed using descriptive statistics.
RESULTS: A total of 171 cases were managed during the study time frame, representing 2.6 % of the total number of adult patients (6511) taken into the clinic. Of the cohort, 139 patients (81.0 %) were followed for more than a year. Nearly all patients (98 %) completed a full panel of recommended baseline lab testing, 88 % met ongoing ALT lab surveillance targets, and 70 % ultrasound surveillance. The majority (83 %) were reviewed by the hepatologist within 6 months.
CONCLUSIONS: This unique model is the first example of a registry of CHB patients in a longitudinal program at a refugee primary care clinic. The observed high rates of adherence were likely achieved by empowering a primary health care interdisciplinary team with specialty support. No funding was utilized for this study.