乙型肝炎的管理：一项全国性纵向调查——加拿大乙型肝炎共识指南的影响
Management of hepatitis B: a longitudinal national survey - impact of the Canadian Hepatitis B Consensus Guidelines.
作者信息
Marotta Paul, Lucas Kurt
机构信息
Liver Transplant Unit, London Health Sciences Centre, London, Ontario.
出版信息
Can J Gastroenterol. 2010 Sep;24(9):537-42. doi: 10.1155/2010/931326.
BACKGROUND
The Canadian Association for the Study of the Liver, and The Association of Medical Microbiology and Infectious Diseases Canada, jointly developed the Canadian Chronic Hepatitis B (HBV) Consensus Guidelines to assist practitioners involved in the management of this complex disease. These guidelines were published in The Canadian Journal of Gastroenterology in June 2007 and distributed to all Canadian gastroenterologists and hepatologists.
OBJECTIVE
To assess the degree to which Canadian specialist physicians were able to incorporate the recommendations from the Canadian HBV Consensus Guidelines into their daily practice.
METHODS
A 30 min telephone survey probing the management strategies of 80 key HBV specialists was completed on three occasions, eight months apart, to longitudinally assess the impact of the Canadian HBV Consensus Guidelines on the management of HBV. The questionnaire detailed HBV practice patterns, the impact of the Canadian HBV Consensus Guidelines on clinical practice and HBV management.
RESULTS
The majority of specialists incorporated many of the published recommendations outlined in the Canadian HBV Consensus Guidelines into their daily practice for patients with HBV. However, because public drug coverage is a major hurdle in the management of HBV, patients are provided markedly different HBV treatments depending on whether they have public or private drug insurance coverage.
CONCLUSIONS
The management of HBV is growing in complexity and continues to evolve rapidly. The Canadian HBV Consensus Guidelines have served as a valuable tool for many physicians in the management of HBV. However, effective treatment algorithms continue to be rendered irrelevant by restrictive drug coverage issues. Coverage for effective therapies and, therefore, management of HBV, differs widely across Canada depending on therapy reimbursement criteria rather than patient characteristics.
背景
加拿大肝脏研究协会与加拿大医学微生物学和传染病协会联合制定了《加拿大慢性乙型肝炎（HBV）共识指南》，以协助参与管理这种复杂疾病的从业者。这些指南于2007年6月发表在《加拿大胃肠病学杂志》上，并分发给了所有加拿大胃肠病学家和肝病学家。
目的
评估加拿大专科医生将《加拿大HBV共识指南》中的建议纳入其日常实践的程度。
方法
进行了一项30分钟的电话调查，对80名主要HBV专家的管理策略进行了三次调查，每次间隔八个月，以纵向评估《加拿大HBV共识指南》对HBV管理的影响。问卷详细询问了HBV的实践模式、《加拿大HBV共识指南》对临床实践和HBV管理的影响。
结果
大多数专家将《加拿大HBV共识指南》中公布的许多建议纳入了他们对HBV患者的日常实践中。然而，由于公共药物覆盖是HBV管理中的一个主要障碍，根据患者是否拥有公共或私人药物保险，他们接受的HBV治疗明显不同。
结论
HBV的管理日益复杂且仍在迅速发展。《加拿大HBV共识指南》已成为许多医生管理HBV的宝贵工具。然而，由于严格的药物覆盖问题，有效的治疗方案仍然无法实施。在加拿大，有效治疗的覆盖范围以及因此对HBV的管理因治疗报销标准而异，而非患者特征。
Zotero 插件