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通过电子病历系统建立高效的院内转诊体系,促进乙型肝炎病毒携带者向肝病专家转诊:一项针对 1281 名医疗保健专业人员的基于多中心问卷调查研究。

Establishing Efficient Systems through Electronic Medical Records to Promote Intra-hospital Referrals of Hepatitis Virus Carriers to Hepatology Specialists: A Multicenter Questionnaire-based Survey of 1,281 Healthcare Professionals.

机构信息

Department of Gastroenterology and Hepatology, Yamaguchi University Hospital, Japan.

Department of Hepatology, Osaka City University Hospital, Japan.

出版信息

Intern Med. 2021;60(3):337-343. doi: 10.2169/internalmedicine.4748-20. Epub 2021 Feb 1.

Abstract

Objective Persistent hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are major causative factors of hepatic cirrhosis and hepatocellular carcinoma. However, the development of antiviral treatment has enabled their suppression. Therefore, the early detection and treatment of these infections are important. The objective of this study was to assess the level of awareness among healthcare professionals about hepatitis virus infection and electronic medical records alert system. Methods We surveyed healthcare professionals from 10 institutions with electronic medical records alert systems. All participants attended a lecture about the reactivation risk due to HBV infections, the most recent antiviral treatment for HCV infections, and the electronic medical records alert system. They participated in a questionnaire-based survey about their awareness of these infections, current status of intra-hospital referral, need for intra-hospital referrals before and after the lecture, and reasons for non-referral of patients to specialists. Results Responses were received from 1,281 healthcare professionals. Physicians and pharmacists had a high level of awareness about HBV and HCV. Among physicians, the level of awareness of those in the surgical field and other fields was significantly lower than that of the professionals in the internal medicine field. The awareness of the need to refer patients to hepatologists increased from 84.7-85.4% before to 93.0% after the lecture. The most frequent reasons for not referring patients previously were "I had no knowledge and/or interest" (28.1% of responses) and "All I did was explain the results orally" (24.2%). Conclusion More widespread education of healthcare personnel is important to increase the number of individuals receiving appropriate treatment from specialist physicians.

摘要

目的

乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)的持续感染是肝硬化和肝细胞癌的主要病因。然而,抗病毒治疗的发展使其得到了抑制。因此,早期检测和治疗这些感染非常重要。本研究的目的是评估医护人员对肝炎病毒感染和电子病历警示系统的认知水平。

方法

我们调查了 10 家拥有电子病历警示系统的医疗机构的医护人员。所有参与者都参加了关于 HBV 感染再激活风险、最新 HCV 感染抗病毒治疗以及电子病历警示系统的讲座。他们参与了一项基于问卷的调查,内容包括他们对这些感染的认识、院内转诊的现状、讲座前后院内转诊的需求以及未将患者转介给专家的原因。

结果

共收到 1281 名医护人员的回复。医生和药剂师对 HBV 和 HCV 的认识水平较高。在医生中,外科和其他领域医生的认知水平明显低于内科医生。将患者转介给肝病专家的意识从讲座前的 84.7%-85.4%增加到了 93.0%。以前未将患者转介的最常见原因是“我没有知识和/或兴趣”(28.1%的回复)和“我只是口头解释结果”(24.2%)。

结论

对医护人员进行更广泛的教育对于增加接受专科医生适当治疗的人数非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c94a/7925281/af1ec05c7081/1349-7235-60-0337-g001.jpg

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