Abstract
An estimated 350 million people worldwide have chronic hepatitis B (CHB), which is a major cause of cirrhosis and hepatocellular carcinoma. To assess the level of knowledge among family medicine trainees regarding the identification and management of CHB. questionnaire to assess knowledge regarding screening and management of patients with CHB and cirrhosis was developed. The questionnaire was pilot tested among primary care physicians, subsequently revised and distributed to family medicine trainees across Canada through an online survey program (QuestionPro). A total of 158 trainees completed the questionnaire. Of these, 54% to 56% routinely offered vaccination against hepatitis A or hepatitis B virus (HBV), and 42% regularly screened patients for HBV risk factors. The percentage who recognized the need to screen highrisk populations for CHB, ie, individuals from an HBV-endemic country, men who have sex with men, or intravenous drug users was 73%, 66% and 74%, respectively. While less than 50% of respondents used the appropriate HBV screening tests, 86% to 91% correctly interpreted various HBV serological patterns. Only 3% recognized cirrhosis in our case scenario. Almost 80% of respondents inappropriately preferred prescribing a narcotic or nonsteroidal anti-inflammatory drug over acetaminophen (4%) for pain control in a patient with cirrhosis. While less than 60% recognized HBeAg negative CHB as an indication for referral and treatment, 90% would have referred a patient in the immune-tolerant phase, even though treatment is not indicated. Knowledge gaps regarding CHB among family medicine trainees in the areas of primary prevention, disease recognition and management of cirrhosis were identified. Results suggest that opportunities to prevent potentially life-threatening complications are being missed.
Highlights
An estimated 350 million people worldwide have chronic hepatitis B (CHB), which is a major cause of cirrhosis and hepatocellular carcinoma
The questionnaire was pilot tested among primary care physicians, subsequently revised and distributed to family medicine trainees across Canada through an online survey program (QuestionPro)
While less than 60% recognized HBeAg negative CHB as an indication for referral and treatment, 90% would have referred a patient in the immune-tolerant phase, even though treatment is not indicated
Summary
An estimated 350 million people worldwide have chronic hepatitis B (CHB), which is a major cause of cirrhosis and hepatocellular carcinoma. MEtHODS: A questionnaire to assess knowledge regarding screening and management of patients with CHB and cirrhosis was developed. CONCLUSiONS: Knowledge gaps regarding CHB among family medicine trainees in the areas of primary prevention, disease recognition and management of cirrhosis were identified. Survey design and content A questionnaire (Appendix 1A) was developed to assess the knowledge of family medicine trainees regarding screening and management of patients with CHB and cirrhosis. The questionnaire focused on vaccination, screening at-risk patients, diagnostic testing, recognizing and managing cirrhosis, indications for specialist referrals, and trainees’ self-assessment of their current and desired knowledge of CHB. Our data were based on self-reports; it is not clear whether our figures reflect actual practice This is the first study to evaluate knowledge levels and screening practices for HBV among family medicine trainees across Canada. What 3 screening tests would you use to identify an individual’s hepatitis B status? 1) ALT / AST 2) HBs Ag 3) anti-HBs 4) HBe Ag 5) anti-HBe 6) anti-HBc (total) Correct answer: 2, 3 and 6
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
