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慢性乙型肝炎——基层医疗服务人员管理的临床审计

Chronic hepatitis B - a clinical audit of GP management.

作者信息

Dev Anouk, Nguyen James Huong, Munafo Lili, Hardie Eve, Iacono Linda

机构信息

Monash Medical Centre, Clayton, Victoria, Australia.

出版信息

Aust Fam Physician. 2011 Jul;40(7):533-8.

Abstract

BACKGROUND

Hepatitis B virus (HBV) infection represents a growing health burden in Australia. This clinical audit aimed to enhance general practitioner awareness of the recommended management for patients with chronic hepatitis B.

OBJECTIVE

This article describes a clinical two-phase audit of 119 Australian GPs who contributed records retrospectively of patients with chronic hepatitis B.

DISCUSSION

Patient records were examined for compliance with prevailing guidelines and GPs received education on guidelines. At completion of the audit 29% of patients were monitored at recommended intervals and 47% were managed according to the current guidelines. Recording of hepatitis B virus DNA results increased from 24% in phase 1 to 63% in phase 2. General practitioners reported increased knowledge of appropriate management and referral. Twenty-five percent of patients audited in both phases had been referred to a specialist. Participating GPs improved their management of patients with chronic hepatitis B. However, there remains considerable scope for enhancing GP understanding of hepatitis B virus and applying current guidelines to clinical practice.

摘要

背景

在澳大利亚,乙型肝炎病毒(HBV)感染给健康带来的负担日益加重。本次临床审计旨在提高全科医生对慢性乙型肝炎患者推荐治疗方案的认识。

目的

本文描述了一项针对119名澳大利亚全科医生的临床两阶段审计,这些医生回顾性地提供了慢性乙型肝炎患者的记录。

讨论

检查患者记录是否符合现行指南,并为全科医生提供指南教育。审计结束时,29%的患者按推荐间隔进行监测,47%的患者按照现行指南进行管理。乙型肝炎病毒DNA检测结果的记录从第一阶段的24%增加到第二阶段的63%。全科医生报告称,他们对适当管理和转诊的知识有所增加。两阶段接受审计的患者中有25%被转诊至专科医生处。参与的全科医生改善了对慢性乙型肝炎患者的管理。然而,在增强全科医生对乙型肝炎病毒的理解并将现行指南应用于临床实践方面,仍有很大空间。

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