Qurashi Maria, von Wagner Christian, Sharma Rohini
Department of Surgery & Cancer, Imperial College London, London, UK.
Department of Epidemiology and Public Health, University College London, London, UK.
J Hepatocell Carcinoma. 2024 Aug 23;11:1597-1605. doi: 10.2147/JHC.S462303. eCollection 2024.
Six-monthly ultrasound surveillance for hepatocellular carcinoma (HCC) is recommended in patients with cirrhosis. Surveillance enhances early detection and improves survival. Yet, despite clear benefits, uptake remains low. We aim to identify and explore ways to overcome patient-related barriers to HCC surveillance with the aim of producing invitations for surveillance.
Using the COM-B model of behaviour and a co-design process, we collaborated with patients, liver health charities and advocacy groups, to identify patient-related barriers to attending HCC surveillance. We performed qualitative thematic analysis of co-production workshops on HCC surveillance to develop information leaflets and surveillance invitations.
Twenty-eight participants attended five workshops. Fear of a serious diagnosis and stigma from healthcare professionals were highlighted as main patient-related barriers to attending surveillance appointments. Co-design was used to develop informative, user-friendly, non-judgemental invitations and information regarding HCC surveillance relevant to populations with cirrhosis.
We identified potential patient barriers to surveillance uptake and developed patient facing material that directly addressed these barriers to be trialled in the clinic. Targeting patient-specific barriers may increase uptake of surveillance and therefore enhance early diagnosis.
对于肝硬化患者，建议每六个月进行一次肝细胞癌（HCC）超声监测。监测可提高早期发现率并改善生存率。然而，尽管有明显益处，但监测的接受度仍然很低。我们旨在识别并探索克服与患者相关的HCC监测障碍的方法，以制定监测邀请。
我们使用行为的COM-B模型和共同设计流程，与患者、肝脏健康慈善机构及倡导团体合作，识别与患者相关的参加HCC监测的障碍。我们对HCC监测共同生产研讨会进行了定性主题分析，以制作信息传单和监测邀请。
28名参与者参加了五次研讨会。对严重诊断的恐惧以及医护人员的污名化被强调为参加监测预约的主要与患者相关的障碍。共同设计被用于制定信息丰富、用户友好、无偏见的邀请以及与肝硬化人群相关的HCC监测信息。
我们识别出了监测接受度方面潜在的患者障碍，并开发了直接解决这些障碍的面向患者的材料，以便在临床中进行试验。针对患者特定障碍可能会提高监测的接受度，从而加强早期诊断。
