Management of chronic Hepatitis B infection in the remote primary health care setting: The search for a suitable guideline

Abstract

To identify a regionally appropriate guideline for the primary health care management of chronic Hepatitis B patients in the Torres Strait. Literature review. PubMed (1950-November 2009), Nursing and allied health (CINAHL)-CD (1982-November 2009), and the following databases accessed through INFORMIT: Australian Public Affairs Information Service-Health (1978-November 2009), Aboriginal and Torres Strait Health Bibliography (1900-November 2009), Health & Society Database (1980-November 2009), Health Collection (1980-November 2009), Meditext (1968-November 2009), and Rural and Remote Health Database (1966-January 2006) were searched over a 3-month period from September to November 2009. An Internet search of relevant guidelines and recommendations from professional bodies such as the World Health Organization was also performed. Remote primary health care. Initial searching identified 144 articles to include based on the provision of recommendations or guidelines for management of Hepatitis B at the primary care level. Included articles were then reviewed for their appropriateness to the remote primary health care setting against a set of five criteria determined at a consensus meeting of eight local medical officers. Eleven articles were included for final review of which none met all five criteria of appropriateness for the remote primary health care setting. Guidelines need to recognize the difficulties of rural and remote practice and present practical alternatives to urban centred recommendations.